Importance of the Early Recognition of Neonatal Seizure Within Midwifery-Led Birthing Units.

Perinatal strokes are strokes occurring from 20 weeks of gestation until 28 days of life. Neonatal strokes are part of this spectrum, with the occurrence of stroke from birth up until 28 days of life. Strokes in neonates can lead to future impairments, for example, motor delay, cognitive or speech issues and epilepsy. We report a case of neonatal stroke leading to prolonged seizure activity. We aim to review the importance of early clinical recognition in identifying neonatal strokes in the hope of improving outcomes. We report the case of a baby girl, born at a gestation of 40+6 weeks. The parents first noticed some abnormal movements of the right hand, which self-resolved. There is no further documentation of the nature of these events whilst the baby was at the birthing centre. No subsequent action regarding these concerns was taken at this point. Subsequently, the baby had several further episodes of seizure activity. This included abnormal limb movements, lip smacking, eye twitching and continuous hiccups. MRI confirmed bilateral middle cerebral artery infarctions. On recent examination, no abnormalities were detected, with a normal Moro reflex and good head control. The infant is due for further review and an MRI within the next few months at the time of writing. In conclusion, it is hoped that the case will help highlight the importance of the early detection of neonatal seizures, including an awareness of red flag signs and symptoms.