Ronit M Pressler - PhD MD MRCPCH Consultant in Clinical Neurophysiology, Great Ormond Street Hospital for Children, Associate Professor in Clinical Neuroscience, UCL Great Ormond Street Institute of Child Health, London, UK

Seizures are the most common neurological emergency in the neonatal period and are associated with mortality and long-term neuro-disability. The clinical diagnosis is challenging because most have no or only discreet clinical manifestation. Depending on the aetiology, up to ۶۰% of seizures are electrographic only. Critically ill infants with a very high seizure burden or in status epilepticus are particularly likely to lack clinical manifestation. Thus, clinical diagnosis is unreliable in most cases making EEG diagnosis a necessity. This makes the integration into a classification serving all ages difficult. Recently the ILAE has published a position paper outlining a new classification for neonatal seizures to provide neonatologists, paediatricians and neurologists a common language to identify, diagnose, and treat neonatal seizures and their acute aetiologies. This classification uses the same framework and terminology as the ۲۰۱۷ ILAE seizure classification, but is tailored towards neonates. All neonatal seizures are considered of focal onset and should be confirmed electrographically. Seizures types include motor events (automatisms, clonic, epileptic spasms, myoclonic, sequential, tonic) or non-motor events (autonomic, behavior arrest) or be electro-graphic only. It allows the user to choose the degree of detail when classifying seizures while takes underlying pathophysiological mechanism into account. A further position paper is in proposed defining and outlining epilepsy syndromes with onset in the neonatal period and infancy.