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A female infant born at 40+3 weeks gestation with a birth weight of 3450 grams. The mother was G2P1 with known hypothyroidism, antibody negative. The pregnancy was uncomplicated and there was spontaneous onset of labour. The amniotic fluid was initially clear when membranes were artificially ruptured, but soon after there was loss of blood. Simultaneously, a deceleration was seen on the CTG. A fetal scalp blood sample showed a pH of 6.84 and an emergency caesarean section was performed. There was no heartbeat, no tone and no spontaneous breathing at
birth. After aspiration of blood from her throat, resuscitation was commenced, initially with mask and bag ventilation, followed by intubation after 7 minutes. Chest compressions were started and two doses of adrenalin were given. The first gasp was seen at 15 minutes. Apgar scores were 0, 3 and 5 at 1, 5 and 10 minutes respectively. At the referring hospital 10 ml/kg saline was given and because of hypotension dopamine was commenced (5 microgram/kg/min). Because of the blood loss an erythrocyte transfusion was also given.
The infant was transported to our NICU because of the severe asphyxia and the need for ventilation and hypothermia treatment.
Please download following .PDF to view the full clinical case study.
Dr. Linda van Rooij
Department of Neonatology,
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This presentation provides a comprehensive review of the 2025 ILAE updates to both the classification of epileptic seizures and epilepsy syndromes. The session will cover the taxonomic framework for seizure
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This presentation provides a comprehensive review of the 2025 ILAE updates to both the classification of epileptic seizures and epilepsy syndromes. The session will cover the taxonomic framework for seizure classification—including the use of consciousness as a classifier, the distinction between observable and non-observable seizure types, and the incorporation of newly recognized entities—as well as the updated approach to syndrome diagnosis across the lifespan. Emphasis will be placed on practical application in clinical care, with case-based examples illustrating how accurate seizure and syndrome classification inform etiology-driven diagnosis, therapeutic choices, and prognostic counseling. Considerations for use in resource-limited settings, research, and policy development will also be discussed.
Learning Objectives:
1. Summarize the 2025 ILAE operational classification of seizures and epilepsy syndromes, including the hierarchical structure and key terminology updates.
2. Differentiate seizure types using the revised criteria for consciousness, observable manifestations, and specific semiologic features.
3. Recognize the major electroclinical syndromes across neonate, infantile, childhood, adolescent, and adult onset groups, and understand their etiologic, prognostic, and therapeutic implications.
4. Integrate seizure classification with syndrome diagnosis to improve diagnostic precision, guide investigations (e.g., genetics, imaging), and inform treatment selection.
5. Apply the updated classifications to real-world clinical scenarios, research studies, and multidisciplinary care planning, including communication with patients, families, and policymakers.
6. Evaluate how these classification updates enhance global harmonization, support education, and align with precision medicine initiatives in epilepsy.
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Nicola Specchio
Nicola Specchio
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Nicola Specchio is Chair of Neurology, Epilepsy and Movement Disorders Unit at Bambino Gesù Children’s Hospital, and Director of Research Unit on Neurological and Neurosurgical Diseases in Rome, Italy, and Guest Professor in Pediatric Neurology at University of Leuven, Belgium.His main interest lies with seizure semiology and the classification of epileptic seizures and syndromes, drug resistant epilepsies, developmental and epileptic encephalopathies. Prof Specchio published more than 280 papers in many international journals and is principal investigator in different clinical trials in patients with rare and complex epilepsies and Developmental and Epileptic encephalopathies.Prof Specchio was recipient of the Young Investigator Award from the Commission of European Affair of the International League Against Epilepsy (2016) and of the “John Stobo Pritchard Award” from the International Child Neurology Association (ICNA) (2020). In 2021 he received the Ambassador for Epilepsy Award from the International Leagues Against Epilepsy.Prof Specchio is currently Past-Chair of the ILAE Terminology Commission, and since 2020 member of the Global Advocacy Council of the International League Against Epilepsy (ILAE). He is also Chair of the International League Against Epilepsy (ILAE) Europe, and board member of the of the International Child Neurology Association (ICNA), and of the Italian Chapter of the ILAE.
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