Neonatal eating epilepsy: 50-year follow-up

PURPOSE We present a case of neonatal eating epilepsy. METHOD Case report. RESULTS An otherwise healthy female newborn started having epileptic seizures lasting up to 5 minutes induced by breastfeeding at age of 2 weeks. The convulsive seizure started with crying and coughing followed by opisthotonus, flexion of upper extremities, extension of lower extremities, and generalized jerks in extremities. The patient had fairly often postictal vomitings which could not be relieved by upright positioning. At baseline clinical examination, no abnormal symptoms or signs were found except for a postictal hoarseness. On the day of admission to the tertiary care hospital, during 1.5 hours, she had 10 attacks. Though some attacks were spontaneous and during sleep, most were induced by feeding or--less often and inconsistently--by manipulating the pharynx. Phenobarbital 15 mg four times a day stopped the attacks. The last seizure was documented 14 days after admission and phenobarbital was eventually withdrawn. The patient remained seizure free off AEDs during a prospective follow-up for over 50 years until 2013. CONCLUSIONS Neonatal eating epilepsy may be a suitable diagnosis if convulsive seizures are precipitated by feeding or eating. Polygraphic recording will help ascertain the diagnosis. Antiepileptic therapy is likely to abolish seizures.