Treatment of seizures in the neonate: Guidelines and consensus-based recommendations. Adnan Hadid

#VirtualNICU Key Clinical Takeaways Don't Rely on Clinical Signs Alone: Neonatal seizures are frequently electrographic-only. Once an ASM is given, clinical signs often disappear while the brain continues to seize (electro-clinical uncoupling). Continuous video EEG is vital. Phenobarbital Remains First-Line: Backed by moderate-quality evidence, phenobarbital is the standard first choice unless a genetic channelopathy is suspected, where a sodium channel blocker is preferred. Discontinue Before Discharge: For acute provoked seizures (like HIE or stroke), ASMs should generally be discontinued before hospital discharge, regardless of what the baseline MRI or background EEG shows. #NeonatalSeizures #ILAE2023 #Neonatology #PediatricNeurology #NICU #Phenobarbital #EEG