What is the investigation of choice for neonatal seizures?

In the context of neonatal seizures, the investigation of choice is an EEG (electroencephalogram). EEG is vital in this scenario because it allows for the assessment of the electrical activity in the brain, which is crucial for diagnosing seizures and determining their origin. Neonatal seizures can manifest in diverse ways, and an EEG provides real-time, continuous monitoring that can capture seizure activities that may be short-lived or not visible on imaging studies.

While both MRI and other imaging modalities like ultrasound can provide valuable structural information, they don't assess the brain's electrical status directly. An MRI may show structural abnormalities such as brain malformations or evidence of hypoxic-ischemic injury but does not provide insight into the ongoing electrical disturbances characterizing seizures. Transcranial ultrasonography (USG) can be useful for assessing the structure and detecting conditions like hemorrhage in neonates, but again, it cannot capture the electrical dynamics of seizure activity.

Thus, the EEG stands out as the definitive tool to confirm the occurrence of seizures in neonates, making it the preferred method in this clinical scenario.