Vegda, HemadriKrishnan, VaisakhVariane, GabrielBagayi, VaishnaviIvain, PhoebePressler, Ronit M.2023-08-192023-08-192022-03Vegda Hemadri, Krishnan Vaisakh, Variane Gabriel, Bagayi Vaishnavi, Ivain Phoebe, Pressler Ronit M.. Neonatal Seizures—Perspective in Low-and Middle-Income Countries. Indian Journal of Pediatrics. 2022 Mar; 89(3): 245–2530973-76930019-5456http://imsear.searo.who.int/handle/123456789/223767Neonatal seizures are the commonest neurological emergency and are associated with poor neurodevelopmental outcome. While they are generally difcult to diagnose and treat, they pose a signifcant clinical challenge for physicians in low- and middle-income countries (LMIC). They are mostly provoked seizures caused by an acute brain insult such as hypoxic– ischemic encephalopathy (HIE), ischemic stroke, intracranial hemorrhage, infections of the central nervous system, or acute metabolic disturbances. Early onset epilepsy syndromes are less common. Clinical diagnosis of seizures in the neonatal period are frequently inaccurate, as clinical manifestations are difcult to distinguish from nonseizure behavior. Additionally, a high proportion of seizures are electrographic-only without any clinical manifestations, making diagnosis with EEG or aEEG a necessity. Only focal clonic and focal tonic seizures can be diagnosed clinically with adequate diagnostic certainty. Prompt diagnosis and timely treatment are important, with evidence suggesting that early treatment improves the response to antiseizure medication. The vast majority of published studies are from high-income countries, making extrapolation to LMIC impossible, thus highlighting the urgent need for a better understanding of the etiologies, comorbidities, and drug trials evaluating safety and efcacy in LMIC. In this review paper, the authors present the latest data on etiology, diagnosis, classifcation, and guidelines for the management of neonates with the emphasis on low-resource settings.Neonatal seizureLow- and middle-income countriesEEGTreatmentJournal ArticleIndiaCenter of Perinatal Neuroscience, Department of Brain Sciences, Imperial College, London, UKNeonatal Intensive Care Unit, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, IndiaInstitute of Maternal and Child Health, Calicut Medical College, Kozhikode, Kerala, IndiaProtecting Brains & Saving Futures, McGill University Health Center/Research Institute of the McGill University Health Center, São Paulo - SP, BrazilNeonatal Intensive Care Unit, Karnataka Institute of Medical Sciences, Hubbali, Karnataka, IndiaCenter for Perinatal Neuroscience, Brain Sciences Department, Imperial College of Science Technology and Medicine, London, UKDepartment of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Trust, London, UKDepartment of Clinical Neuroscience, UCL- Great Ormond Street Institute of Child Health, London WCIN IEH, UK