Research issues in neonatal seizures

Neonatal seizures are a common and serious problem. There are many management related issues that have no sufficient evidence to support current practices. Most units in the world do not have facilities to monitor EEG at the time ‘seizures’ occur. Also non - availability of trained personnel who can interpret neonatal EEG further limits diagnosis to clinical observation. There is a need for a tool that is easier to use and interpret and also to develop clinical diagnostic algorithms that may allow diagnosis of seizures with reasonable accuracy. Newer AEDs are being used more often with the expectation of being better with respect to the developing brain; but most haven't been tested systematically. The thresholds for starting AED, escalating therapy and discontinuing seizures are not based on evidence. There is a need to report longer follow ups in these vulnerable neonates. The document explores possible areas of research in neonatal seizures and proposes models that may be useful for a developing country.