case_images: PMC11218545_01
case_images: The characteristics of amplitude-integrated electroencephalography in neonatal seizures induced by community-acquired acute severe hyponatremia. (A) The aEEG presentation of a healthy full-term newborn. In a healthy full-term newborn, the aEEG trace typically fluctuates between wider and narrower patterns, reflecting periods of quiet sleep (QS) and periods of awake/active sleep (AS), respectively. During QS, the recording shows a more discontinuous pattern with the lower margin voltage (LMV) often dropping below 5 muV. Conversely, in AS and when the baby is awake, the LMV remains well above 5 muV. Regardless of the sleep state:AS or QS:the upper margin voltage (UMV) stays above 10 muV. This regular fluctuation is known as the "continuous normal voltage" (CNV) pattern and is generally straightforward for aEEG practitioners to recognize. (B) The aEEG patterns during severe hyponatremia-induced seizure episodes. The aEEG captured seizure activity characterized by the absence of sleep-wake rhythmicity, a pronounced elevation in both the lower and upper amplitude margins, with a sustained decrease in the lower margin voltage falling below 5 muV, manifesting as distinct sharp or serrated waveforms. (C) post-seizure control aEEG characteristics in community-acquired acute severe hyponatremia. After seizure management, the aEEG patterns have reverted to those observed in healthy full-term newborn.
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case_images: PMC11218545_01_fphar-15-1391024-g001.jpg
case_images: F1
case_images: The cerebrospinal fluid and cranial ultrasound showed no evidence of bacterial meningitis or intracranial hemorrhage, but aEEG confirmed seizure activity (Figure 1B; Supplementary Video S1). We corrected the magnesium deficiency using magnesium sulfate and provided Vitamin B6 supplementation via a peripheral central venous catheter (PICC) (Figure 2C); however, the seizures persisted until the fourth administration of 3% hypertonic saline (Figure 3) successfully halted the convulsions (Figure 1C).
case_images: Imaging features in neonatal seizures induced by community-acquired acute severe hyponatremia. (A, B): bedside chest and abdominal X-rays reveal scattered patchy and nodular densities along the pulmonary markings in the middle and lower lung fields bilaterally, presenting with blurred and poorly defined margins. There is a noticeable presence of gas within the colon. (C) chest and abdominal imaging under mechanical ventilation and peripheral central venous catheter. (D) abdominal imaging reexamination reveals a reduction in intestinal gas compared to previous assessment 2 days post-admission.
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case_images: PMC11218545_01_fphar-15-1391024-g002.jpg
case_images: F2
case_images: Bedside chest and abdominal X-rays reveal scattered patchy and nodular densities along the pulmonary markings in the middle and lower lung fields bilaterally, presenting with blurred and poorly defined margins, indicated neonatal pneumonia (Figure 2A). Additionally, there is a noticeable presence of gas within the colon (Figure 2B). We corrected the magnesium deficiency using magnesium sulfate and provided Vitamin B6 supplementation via a peripheral central venous catheter (PICC) (Figure 2C); however, the seizures persisted until the fourth administration of 3% hypertonic saline (Figure 3) successfully halted the convulsions (Figure 1C). Abdominal X-ray reexamination revealed a reduction in intestinal gas compared to previous assessment (Figure 2D).
case_images: Sodium level dynamics in neonatal seizures induced by community-acquired acute severe hyponatremia. Black arrows mark the moments of 3% hypertonic saline supplementation, administered at 2, 6, 9, and 13 h post-admission.
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case_images: PMC11218545_01_fphar-15-1391024-g003.jpg
case_images: F3
case_images: We corrected the magnesium deficiency using magnesium sulfate and provided Vitamin B6 supplementation via a peripheral central venous catheter (PICC) (Figure 2C); however, the seizures persisted until the fourth administration of 3% hypertonic saline (Figure 3) successfully halted the convulsions (Figure 1C).