Infantile spasms (IS) are a distinctive form of seizure disorder, mainly observed in infants, in the first year of life, and refractory to conventional antiepileptic drugs. IS are manifested as clusters of increasing plateau-decreasing-intensity brisk flexions or extensions of the neck, with abduction or adduction of the upper limbs. IS must be differentiated from rarer, earlier-onset conditions with ominous prognosis, such as early infantile epileptic encephalopathy and early myoclonic encephalopathy. Differentiating IS from the tonic seizures of Lennox-Gastaut syndrome may be difficult, especially when the attacks are in extension and not repeated in clusters. West syndrome may evolve into Lennox-Gastaut syndrome. The prognosis of IS is heavily influenced by the pathological process underlying the syndrome. Brain MRI has a high prognostic value, which is closely linked to its diagnostic power. Randomized clinical trials in Lennox-Gastaut syndrome have been performed for lamotrigine, topiramate, felbamate, rufinamide, thyrotropin-releasing hormone (TRH) analog, and cinromide.

The average age of childhood status epilepticus (SE) is under 3 years old. The acute management requires a planned treatment schedule and a specific time line. The duration of SE is the greatest risk to the patient; the longer SE lasts, the more difficult it is to treat. The three goals of treatment are to control seizures, to preserve vital functions, and to diagnose the underlying pathology. Absence SE, partial absence SE, or complex partial SE may present as nonconvulsive SE. Neonatal seizures occur in patients under 29 days old, and they are usually related to significant neurological disease. Pediatric patients are unique in that several characteristic epileptic syndromes have an age-dependent appearance, one or more characteristic seizure types, a natural history, and a prognosis. Some major syndromes include febrile seizures, infantile spasms, Lennox-Gastaut syndrome, and benign rolandic epilepsy (BRE).