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- Create Date July 26, 2017
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A female infant born at 38+4 weeks gestation with a birth weight of 3170 grams. The mother was G1P0. She was admitted for induction at 38+4 weeks gestation because of pregnancy induced hypertension. On rupture of the membranes there was blood loss and on CTG a fetal tachycardia was seen. An emergency caesarean section was performed and during the resuscitation the infant had profound bradycardia with no spontaneous breathing effort. After 5 inflation breaths the heart rate increased and after 10 minutes she was breathing spontaneously but with an irregular breathing pattern. Apgar scores were 2, 5 and 7 at 1, 5 and 10 minutes respectively. She was admitted to the neonatal unit in an outlying hospital where she stabilized quickly. Her first glucose level was 3.6 mmol/L and she had a capillary sample lactate of 11.2 mmol/L. Around 12 hours after birth she had an incident of bradycardia, followed by a drop of oxygen saturation and thereafter clinical seizure like activity involving both arms and legs. A loading dose of phenobarbitone (20 mg/kg) was given. Ten hours later she developed clinical seizures again with movements of her right arm and a drop in oxygen saturation. Another dose of phenobarbitone was given and she was transported to our NICU for further cerebral monitoring and investigation.
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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