Elwadhi, AmanKandraju, HemasreeSharma, Suvasini2025-08-132025-08-132025-05Elwadhi Aman, Kandraju Hemasree, Sharma Suvasini . Advances in Neonatal Seizures (2024): An Update for Pediatricians. Indian Pediatrics. 2025 May; 62(5): 386-3900019-60610974-7559https://imsear.searo.who.int/handle/123456789/251344Purpose The diagnosis and management of seizures and epilepsy syndromes with onset in neonates has undergone several changes following the Interna?on League against Epilepsy (ILAE) guidelines. To update the Pediatricians regarding the recent advances, this update was planned. Methods Recently published revised guidelines for neonatal seizures (up to 2024) by ILAE were reviewed and synthesized. Results Video-EEG recording is considered gold standard for diagnosis, with less emphasis on clinical semiology. In resource limited se?ngs, levels of diagnos?c certain?es may be used. One must be aware of the mandatory, alerts and exclusion criteria for various neonatal-onset epilepsy syndromes. Early neuroimaging facilitates diagnosis. Treatment primarily involves phenobarbitone (PHB) with other drugs to be used in certain special condi?ons, with universal early stoppage of drugs. Precision therapy is available for some metabolic and gene?c e?ologies. Conclusions EEG monitoring in high-risk neonates is the standard of care. PHB s?ll remains the first choice. Early cessa?on of an?-seizure medica?ons in acute symptoma?c seizures is the norm.Neonatal epilepsyDevelopmental and epileptic encephalopathyPrecision medicineJournal ArticleIndiaDepartment of Pediatrics, ESIC Model Hospital and PGIMSR, Basaidarapur, New Delhi, IndiaBrampton Civic Hospital, William Osler Health System, Brampton, ON, CanadaNeurology Division, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.