{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T16:00:35Z","timestamp":1794499235213,"version":"4.9.1"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Indian J Pediatr"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Neonatal seizures are the commonest neurological emergency and are associated with poor neurodevelopmental outcome. While they are generally difficult to diagnose and treat, they pose a significant 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\u2013ischemic 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 difficult 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 efficacy in LMIC. In this review paper, the authors present the latest data on etiology, diagnosis, classification, and guidelines for the management of neonates with the emphasis on low-resource settings.<\/jats:p>","DOI":"10.1007\/s12098-021-04039-2","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T11:05:36Z","timestamp":1642676736000},"page":"245-253","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Neonatal Seizures\u2014Perspective in Low-and Middle-Income Countries"],"prefix":"10.1007","volume":"89","author":[{"given":"Hemadri","family":"Vegda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaisakh","family":"Krishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Variane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishnavi","family":"Bagayi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe","family":"Ivain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2905-6839","authenticated-orcid":false,"given":"Ronit M.","family":"Pressler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"4039_CR1","doi-asserted-by":"crossref","unstructured":"Abend AS, Jensen FE, Inder TE, Volpe JJ. Neotal seizures. In: Volpe JJ, Inder T, Darras B, et al., eds. Volpe's Neurology of the Newborn. 6th ed. Philadelphia: PA Elsevier; 2018. pp 275\u2013321.","DOI":"10.1016\/B978-0-323-42876-7.00012-0"},{"key":"4039_CR2","doi-asserted-by":"publisher","first-page":"7596","DOI":"10.1016\/j.vaccine.2019.05.031","volume":"37","author":"S Pellegrin","year":"2019","unstructured":"Pellegrin S, Munoz FM, Padula M, et al. Neonatal seizures: case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2019;37:7596\u2013609.","journal-title":"Vaccine"},{"key":"4039_CR3","first-page":"760","volume":"50","author":"A Sadeghian","year":"2012","unstructured":"Sadeghian A, Damghanian M, Shariati M. Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors. Acta Med Iran. 2012;50:760\u20134.","journal-title":"Acta Med Iran"},{"key":"4039_CR4","doi-asserted-by":"crossref","unstructured":"Ghanshyambhai P, Sharma D, Patel A, Shastri S. To study the incidence, etiology and EEG profile of neonatal seizures: A prospective observational study from India. J Matern Fetal Neonatal\u00a0Med. 2016;29:554\u20138.","DOI":"10.3109\/14767058.2015.1010199"},{"key":"4039_CR5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.4103\/jcn.JCN_70_19","volume":"9","author":"B Nair","year":"2020","unstructured":"Nair B, Sharma J, Chaudhary S. Clinicoetiological profile of neonatal seizure in a newborn care unit of a tertiary care teaching hospital in Northern India. J Clin Neonatol. 2020;9:27\u201331.","journal-title":"J Clin Neonatol"},{"key":"4039_CR6","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1212\/WNL.37.12.1837","volume":"37","author":"EM Mizrahi","year":"1987","unstructured":"Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurology. 1987;37:1837\u201344.","journal-title":"Neurology"},{"key":"4039_CR7","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1212\/WNL.0b013e318211c19e","volume":"76","author":"NS Abend","year":"2011","unstructured":"Abend NS, Gutierrez-Colina AM, Topjian AA, et al. Nonconvulsive seizures are common in critically ill children. Neurology. 2011;76:1071\u20137.","journal-title":"Neurology"},{"key":"4039_CR8","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jpeds.2016.03.035","volume":"174","author":"HC Glass","year":"2016","unstructured":"Glass HC, Shellhaas RA, Wusthoff CJ, et al. Contemporary profile of seizures in neonates: a prospective cohort study. J Pediatr. 2016;174:98\u2013103.","journal-title":"J Pediatr"},{"key":"4039_CR9","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/WNP.0b013e3182872b24","volume":"30","author":"TN Tsuchida","year":"2013","unstructured":"Tsuchida TN, Wusthoff CJ, Shellhaas RA, et al. American clinical neurophysiology society standardized EEG terminology and categorization for the description of continuous EEG monitoring in neonates: report of the American Clinical Neurophysiology Society critical care monitoring committee. J Clin Neurophysiol. 2013;30:161\u201373.","journal-title":"J Clin Neurophysiol"},{"key":"4039_CR10","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1038\/s41390-018-0242-2","volume":"85","author":"JS Soul","year":"2019","unstructured":"Soul JS, Pressler R, Allen M, et al. Recommendations for the design of therapeutic trials for neonatal seizures. Pediatr Res. 2019;85:943\u201354.","journal-title":"Pediatr Res"},{"key":"4039_CR11","first-page":"24","volume":"8","author":"MK Sabzehei","year":"2014","unstructured":"Sabzehei MK, Basiri B, Bazmamoun H. The etiology, clinical type, and short outcome of seizures in newbornshospitalized in Besat hospital\/Hamadan\/ Iran. Iran J Child Neurol. 2014;8:24\u20138.","journal-title":"Iran J Child Neurol"},{"key":"4039_CR12","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1741-7015-8-16","volume":"8","author":"M Mwaniki","year":"2010","unstructured":"Mwaniki M, Mathenge A, Gwer S, et al. Neonatal seizures in a rural Kenyan District Hospital: aetiology, incidence and outcome of hospitalization. BMC Med. 2010;8:16.","journal-title":"BMC Med"},{"key":"4039_CR13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.seizure.2020.12.023","volume":"85","author":"F Pisani","year":"2021","unstructured":"Pisani F, Spagnoli C, Falsaperla R, Nagarajan L, Ramantani G. Seizures in the neonate: A review of etiologies and outcomes. Seizure. 2021;85:48\u201356.","journal-title":"Seizure"},{"key":"4039_CR14","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/B978-0-444-64029-1.00017-5","volume":"162","author":"RA Shellhaas","year":"2019","unstructured":"Shellhaas RA. Seizure classification, etiology, and management. Handb Clin Neurol. 2019;162:347\u201361.","journal-title":"Handb Clin Neurol"},{"key":"4039_CR15","doi-asserted-by":"crossref","first-page":"211","DOI":"10.4103\/2667-3592.301388","volume":"7","author":"K Reddy","year":"2018","unstructured":"Reddy K, Soren C, Jagtap S, Pardhasaradhi Y, Satish S. Clinico-etiological profile of neonatal seizures in term neonates. J Pediatr Assoc India. 2018;7:211.","journal-title":"J Pediatr Assoc India"},{"key":"4039_CR16","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.eclinm.2018.12.001","volume":"6","author":"CJ Tann","year":"2018","unstructured":"Tann CJ, Webb EL, Lassman R, et al. Early childhood outcomes after neonatal encephalopathy in Uganda: a cohort study. E Clinical Medicine. 2018;6:26\u201335.","journal-title":"EClinicalMedicine"},{"key":"4039_CR17","doi-asserted-by":"crossref","unstructured":"Pressler RM, Cilio MR, Mizrahi EM, et al. The ILAE classification of seizures and the epilepsies: modification for seizures in the neonate. Position paper by the ILAE task force on neonatal seizures. Epilepsia. 2021;62:615\u201328.","DOI":"10.1111\/epi.16815"},{"key":"4039_CR18","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1212\/WNL.0b013e31820af91a","volume":"76","author":"KB Nash","year":"2011","unstructured":"Nash KB, Bonifacio SL, Glass HC, et al. Video-EEG monitoring in newborns with hypoxic-ischemic encephalopathy treated with hypothermia. Neurology. 2011;76:556\u201362.","journal-title":"Neurology"},{"key":"4039_CR19","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1111\/epi.13670","volume":"58","author":"RS Fisher","year":"2017","unstructured":"Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International league against epilepsy: position paper of the ILAE Commission for classification and terminology. Epilepsia. 2017;58:522\u201330.","journal-title":"Epilepsia"},{"key":"4039_CR20","doi-asserted-by":"publisher","first-page":"F187","DOI":"10.1136\/adc.2005.086314","volume":"93","author":"DM Murray","year":"2008","unstructured":"Murray DM, Boylan GB, Ali I, Ryan CA, Murphy BP, Connolly S. Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures. Arch Dis Child Fetal Neonatal Ed. 2008;93:F187\u201391.","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"4039_CR21","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.1111\/j.1528-1167.2009.02132.x","volume":"50","author":"A Malone","year":"2009","unstructured":"Malone A, Ryan CA, Fitzgerald A, Burgoyne L, Connolly S, Boylan GB. Interobserver agreement in neonatal seizure identification. Epilepsia. 2009;50:2097\u2013101.","journal-title":"Epilepsia"},{"key":"4039_CR22","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/B978-0-444-64029-1.00018-7","volume":"162","author":"GB Boylan","year":"2019","unstructured":"Boylan GB, Kharoshankaya L, Mathieson SR. Diagnosis of seizures and encephalopathy using conventional EEG and amplitude integrated EEG. Handb Clin Neurol. 2019;162:363\u2013400.","journal-title":"Handb Clin Neurol"},{"key":"4039_CR23","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1055\/s-0038-1676052","volume":"36","author":"GF Variane","year":"2019","unstructured":"Variane GF, Cunha LM, Pinto P, et al. Therapeutic hypothermia in Brazil: a multiProfessional national survey. Am J Perinatol. 2019;36:1150\u20136.","journal-title":"Am J Perinatol"},{"key":"4039_CR24","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.jped.2016.12.003","volume":"93","author":"GFT Variane","year":"2017","unstructured":"Variane GFT, Magalh\u00e3es M, Gasperine R, et al. Early amplitude-integrated electroencephalography for monitoring neonates at high risk for brain injury. J Pediatr (Rio J). 2017;93:460\u20136.","journal-title":"J Pediatr (Rio J)"},{"key":"4039_CR25","doi-asserted-by":"crossref","unstructured":"Kadivar M, Moghadam EM, Shervin Badv R, Sangsari R, Saeedy M. A comparison of conventional electroencephalography with amplitude-integrated eeg in detection of neonatal seizures. Med\u00a0Devices (Auckl). 2019;12:489\u201396.","DOI":"10.2147\/MDER.S214662"},{"key":"4039_CR26","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1097\/WNP.0b013e31823e96d7","volume":"28","author":"RA Shellhaas","year":"2011","unstructured":"Shellhaas RA, Chang T, Tsuchida T, et al. The American clinical neurophysiology society\u2019s guideline on continuous electroencephalography monitoring in neonates. J Clin Neurophysiol. 2011;28:611\u20137.","journal-title":"J Clin Neurophysiol"},{"key":"4039_CR27","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1177\/0883073808327832","volume":"24","author":"HC Glass","year":"2009","unstructured":"Glass HC, Wirrell E. Controversies in neonatal seizure management. J Child Neurol. 2009;24:591\u20139.","journal-title":"J Child Neurol"},{"key":"4039_CR28","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1177\/0883073816664670","volume":"31","author":"ML Harris","year":"2016","unstructured":"Harris ML, Malloy KM, Lawson SN, Rose RS, Buss WF, Mietzsch U. Standardized treatment of neonatal status epilepticus improves outcome. J Child Neurol. 2016;31:1546\u201354.","journal-title":"J Child Neurol"},{"key":"4039_CR29","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1212\/WNL.55.4.506","volume":"55","author":"MC McBride","year":"2000","unstructured":"McBride MC, Laroia N, Guillet R. Electrographic seizures in neonates correlate with poor neurodevelopmental outcome. Neurology. 2000;55:506\u201313.","journal-title":"Neurology"},{"key":"4039_CR30","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.siny.2013.04.004","volume":"18","author":"GB Boylan","year":"2013","unstructured":"Boylan GB, Stevenson NJ, Vanhatalo S. Monitoring neonatal seizures. Semin Fetal Neonatal Med. 2013;18:202\u20138.","journal-title":"Semin Fetal Neonatal Med"},{"key":"4039_CR31","first-page":"e350","volume":"5","author":"CD Hahn","year":"2004","unstructured":"Hahn CD, Riviello JJ. Neonatal Seizures and EEG. Electroclinical Dissociation and Uncoupling Neo Reviews. 2004;5:e350\u20135.","journal-title":"Electroclinical Dissociation and Uncoupling Neo Reviews"},{"key":"4039_CR32","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1177\/0883073812470734","volume":"28","author":"LA Slaughter","year":"2013","unstructured":"Slaughter LA, Patel AD, Slaughter JL. Pharmacological treatment of neonatal seizures: a systematic review. J Child Neurol. 2013;28:351\u201364.","journal-title":"J Child Neurol"},{"key":"4039_CR33","unstructured":"Sharpe C, Reiner GE, Davis SL, et al. Levetiracetam versus phenobarbital for neonatal seizures: a randomized controlled trial. Pediatrics. 2020;145:e20193182."},{"key":"4039_CR34","volume-title":"Guidelines on Neonatal Seizures","author":"WHO Guidelines Approved by the Guidelines Review Committee","year":"2011","unstructured":"WHO Guidelines Approved by the Guidelines Review Committee. Guidelines on Neonatal Seizures. Geneva: World Health Organization; 2011."},{"key":"4039_CR35","doi-asserted-by":"publisher","unstructured":"Booth D, Evans DJ. Anticonvulsants for neonates with seizures. Cochrane Database Syst Rev. 2004:Cd004218. https:\/\/doi.org\/10.1002\/14651858.CD004218.pub2.","DOI":"10.1002\/14651858.CD004218.pub2"},{"key":"4039_CR36","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/S1474-4422(14)70110-3","volume":"13","author":"O Dulac","year":"2014","unstructured":"Dulac O, Plecko B, Gataullina S, Wolf NI. Occasional seizures, epilepsy, and inborn errors of metabolism. Lancet neurol. 2014;13:727\u201339.","journal-title":"Lancet neurol"},{"key":"4039_CR37","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1055\/s-0039-1693149","volume":"50","author":"G Ramantani","year":"2019","unstructured":"Ramantani G, Schmitt B, Plecko B, et al. Neonatal seizures-are we there yet? Neuropediatrics. 2019;50:280\u201393.","journal-title":"Neuropediatrics"},{"key":"4039_CR38","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.3390\/ijms18071384","volume":"18","author":"S Sharma","year":"2017","unstructured":"Sharma S, Prasad AN. Inborn errors of metabolism and epilepsy: current understanding, diagnosis, and treatment approaches. Int J Mol Sci. 2017;18:1384.","journal-title":"Int J Mol Sci"},{"key":"4039_CR39","doi-asserted-by":"crossref","unstructured":"Hellstr\u00f6m-Westas L, Blennow G, Lindroth M, Ros\u00e9n I, Svenningsen NW. Low risk of seizure recurrence after early withdrawal of antiepileptic treatment in the neonatal period. Arch Dis Child Fetal Neonatal\u00a0Ed. 1995;72:F97\u2013101.","DOI":"10.1136\/fn.72.2.F97"},{"key":"4039_CR40","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1542\/peds.2005-1178","volume":"117","author":"H Tekgul","year":"2006","unstructured":"Tekgul H, Gauvreau K, Soul J, et al. The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics. 2006;117:1270\u201380.","journal-title":"Pediatrics"},{"key":"4039_CR41","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1111\/dmcn.14174","volume":"61","author":"A Oh","year":"2019","unstructured":"Oh A, Thurman DJ, Kim H. Independent role of neonatal seizures in subsequent neurological outcomes: a population-based study. Dev Med Child Neurol. 2019;61:661\u20136.","journal-title":"Dev Med Child Neurol"},{"key":"4039_CR42","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jpeds.2008.07.008","volume":"154","author":"HC Glass","year":"2009","unstructured":"Glass HC, Pham TN, Danielsen B, Towner D, Glidden D, Wu YW. Antenatal and intrapartum risk factors for seizures in term newborns: a population-based study, California 1998\u20132002. J Pediatr. 2009;154:24\u20138.","journal-title":"J Pediatr"},{"key":"4039_CR43","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1111\/dmcn.13215","volume":"58","author":"L Kharoshankaya","year":"2016","unstructured":"Kharoshankaya L, Stevenson NJ, Livingstone V, et al. Seizure burden and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy. Dev Med Child Neurol. 2016;58:1242\u20138.","journal-title":"Dev Med Child Neurol"},{"key":"4039_CR44","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1159\/000494702","volume":"52","author":"A Andreolli","year":"2019","unstructured":"Andreolli A, Turco EC, Pedrazzi G, Beghi E, Pisani F. Incidence of epilepsy after neonatal seizures: a population-based study. Neuroepidemiology. 2019;52:144\u201351.","journal-title":"Neuroepidemiology"},{"key":"4039_CR45","doi-asserted-by":"publisher","first-page":"e1302","DOI":"10.1542\/peds.2014-3777","volume":"136","author":"P Srinivasakumar","year":"2015","unstructured":"Srinivasakumar P, Zempel J, Trivedi S, et al. Treating EEG seizures in hypoxic ischemic encephalopathy: a randomized controlled trial. Pediatrics. 2015;136:e1302\u20139.","journal-title":"Pediatrics"},{"key":"4039_CR46","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.pediatrneurol.2004.11.005","volume":"32","author":"MC Toet","year":"2005","unstructured":"Toet MC, Groenendaal F, Osredkar D, van Huffelen AC, de Vries LS. Postneonatal epilepsy following amplitude-integrated EEG-detected neonatal seizures. Pediatric Neurol. 2005;32:241\u20137.","journal-title":"Pediatric Neurol"},{"key":"4039_CR47","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.pediatrneurol.2016.07.007","volume":"64","author":"RA Bashir","year":"2016","unstructured":"Bashir RA, Espinoza L, Vayalthrikkovil S, et al. Implementation of a neurocritical care program: improved seizure detection and decreased antiseizure medication at discharge in neonates with hypoxic-ischemic encephalopathy. Pediatr Neurol. 2016;64:38\u201343.","journal-title":"Pediatr Neurol"},{"key":"4039_CR48","doi-asserted-by":"publisher","unstructured":"Krishnan V, Kumar V, Variane GFT, et al. Need for more evidence in the prevention and management of perinatal asphyxia and neonatal encephalopathy in low and middle-income countries: A call for action. Semin Fetal Neonatal Med. 2021:101271. https:\/\/doi.org\/10.1016\/j.siny.2021.101271.","DOI":"10.1016\/j.siny.2021.101271"}],"container-title":["Indian Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12098-021-04039-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12098-021-04039-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12098-021-04039-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T01:34:56Z","timestamp":1700098496000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12098-021-04039-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,20]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["4039"],"URL":"https:\/\/doi.org\/10.1007\/s12098-021-04039-2","relation":{},"ISSN":["0019-5456","0973-7693"],"issn-type":[{"value":"0019-5456","type":"print"},{"value":"0973-7693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,20]]},"assertion":[{"value":"18 November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ronit M. Pressler has served as an investigator for studies with UCB and Johnson & Johnson. She has received honoraria for educational symposia, advisory boards, and consultancy work from GW Pharma, Natus, UCB, and Esai. She is consulting for Kephala. Gabriel Variane works for Protecting Brains and Saving Futures (PBSF).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}