Neonatal Neurological Emergencies

Encephalopathy, or an altered state of consciousness, presents a diagnostic challenge to clinicians involved in the care of neonates. Unlike older age groups where neurological dysfunction almost invariably suggests central nervous system disease, the neonate will present with an acute encephalopathy when severe illness arises within or outside the central nervous system. This article is intended to highlight the various neonatal conditions that may present with disturbed neurological function (seizures and altered states of consciousness) to the emergency department, and emergency physicians must be aware of the extensive differential diagnoses associated with such presentations. It cannot be overemphasized that a detailed history from a caregiver and a thorough physical examination are essential to identify potentially treatable etiologies.