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Advances in Neonatal Seizures (2024): An Update for Pediatricians

Aman Elwadhi1, Hemasree Kandraju2, Suvasini Sharma3

  • 1Department of Pediatrics, ESIC Model Hospital and PGIMSR, Basaidarapur, New Delhi, India.

Indian Pediatrics
|April 15, 2025
PubMed

Insights

Updated guidelines for neonatal seizures emphasize EEG monitoring and phenobarbitone (PHB) as first-line treatment. Early drug cessation is recommended for acute symptomatic seizures in neonates.

Area of Science:

  • Neonatal Neurology
  • Pediatric Epilepsy
  • Clinical Neurophysiology

Background:

  • Neonatal seizures and epilepsy syndromes have evolving diagnostic and management criteria.
  • Recent International League Against Epilepsy (ILAE) guidelines have introduced significant updates.
  • Pediatricians require updated information on these advances.

Purpose of the Study:

  • To synthesize recent ILAE guidelines (up to 2024) for neonatal seizures.
  • To provide an update for pediatricians on the latest advances in neonatal epilepsy management.
  • To highlight changes in diagnosis and treatment protocols.

Main Methods:

  • Review and synthesis of recently published ILAE guidelines for neonatal seizures (up to 2024).

Main Results:

  • Video-electroencephalogram (EEG) recording is the gold standard for neonatal seizure diagnosis.
  • Diagnostic certainty levels are applicable in resource-limited settings.
  • Early neuroimaging aids diagnosis; phenobarbitone (PHB) is the primary treatment, with early drug cessation recommended.
  • Precision therapies exist for specific metabolic and genetic causes.

Conclusions:

  • EEG monitoring is the standard of care for high-risk neonates.
  • Phenobarbitone (PHB) remains the preferred first-line anti-seizure medication.
  • Early discontinuation of anti-seizure medications is standard practice for acute symptomatic seizures.
Abstract

Keywords:
Developmental and epileptic encephalopathyNeonatal epilepsyPrecision medicine

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