Table 2

Suggested investigations useful in determining the cause of neonatal seizures

ApproachPossible investigations
Initial screen (for acute symptomatic seizures)Liver function test
Renal function test
Calcium and magnesium
Glucose
Blood cultures
Lumbar puncture
Urine culture
Cranial ultrasound/magnetic resonance imaging
Possible second-line investigationsElectroencephalography
Lactate
Acylcarnitines
Ammonia
Urate
Biotinidase
Copper, caeruloplasmin and hair analysis
Plasma and urine amino acids
Urine organic acids
Paired cerebrospinal fluid (CSF) and plasma amino acids (includes glycine and serine)
Paired CSF and plasma glucose and lactate (if not done already for glucose transporter type 1 deficiency syndrome)
Urine alpha aminoadipic semialdehyde (αAASA) (or plasma/CSF pipecolic acid if not available)
Urine sulfites
Congenital infection screen