Non epileptiform abnormal neurologic signs in newborns following in-utero psychotropic medication exposure
Author Department
Pediatrics
Document Type
Article, Peer-reviewed
Publication Date
7-2024
Abstract
Background: Post natal adaptation syndrome is well reported but early presentation of neurological symptoms severe enough to warrant detailed neurological work up is rare. Our aim was to evaluate and describe abnormal early neurological symptoms in infants following in-utero exposure to a varying combination of selective serotonin uptake inhibitor medication and other psychotropic medications, with negative seizure work-up.
Method: Descriptive case series of infant exposed to selective serotonin uptake inhibitor medication and other psychotropic medications, presenting with early neurologic signs and symptoms within the first 24 hours of life concerning for seizures, who underwent an extensive neurologic evaluation.
Results: Five infants met criteria. Infant #1 : 39-weeks gestational age (GA), with escitalopram, clonazepam, gabapentin, methadone exposure, presented with generalized hypertonia and intermittent back-arching. #2 : 40-weeks GA with escitalopram and hydroxyzine exposure, with bilateral arm stiffening and sucking mouth movements. #3 : 34-weeks GA with fluoxetine, quetiapine and clonazepam exposure, presented with decerebrate posturing. #4 : 38-weeks GA with fluoxetine, clonazepam, clonidine, quetiapine and gabapentin exposure, presented with asynchronous tremoring of all extremities. #5 : 35-weeks GA with citalopram, quetiapine exposure, presented with increased tone and posturing of upper extremities. Electroencephalogram was negative for seizures in all infants.
Conclusion: In-utero exposure to selective serotonin uptake inhibitor medication, especially in combination with other psychotropic medications, may be associated with significant abnormal neurological symptoms, which may not represent true seizures.
Keywords: Post natal adaptation syndrome; seizure-like movements; selective serotonin uptake inhibitor.
Recommended Citation
Vaidya R, Hashmi N, Kakshapati S, Chang W, Beachy J. Non epileptiform abnormal neurologic signs in newborns following in-utero psychotropic medication exposure. J Neonatal Perinatal Med. 2024 Jul 23. doi: 10.3233/NPM-230165. Epub ahead of print.
PMID
39058453