Neonatal seizures are usually considered of epileptic origin, although some may be generated by non-epileptic mechanisms. Neonatal seizures may be classified by clinical features: focal clonic, focal tonic, myoclonic, spasms, generalized tonic and motor automatisms. The main categories of etiological factors of neonatal seizures include hypoxic- ischemic encephalopathy, central nervous system (CNS) infections, structural brain abnormalities, and metabolic disturbances. Early neuroimaging studies, particularly magnetic resonance imaging (MRI) with diffusion imaging, should show acute diffuse abnormalities consistent with hypoxia/ischemia. Some neonatal seizures result from long-standing disorders. These disorders include cerebral dysgenesis, neurocutaneous syndromes, genetic disorders, or very early onset epilepsy in association with well-defined epileptic syndromes. Clinical examination and seizure characterization are initial points of reference in the evaluation of infants suspected of early myoclonic encephalopathy (EME). Benzodiazepines are frequently used as alternative secondline antiepileptic drugs (AEDs), although more often they are given following phenobarbital and in place of phenytoin.

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).