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ArticlePediatric research2026

Electrographic-only seizures and status epilepticus in neonates with Tuberous Sclerosis Complex.

Serena Pellegrin, Massimo Mastrangelo, Patrizia Accorsi, Susanna Casellato, Elisabetta Cesaroni, Lucrezia De Cosmo, Paola De Liso, Robertino Dilena, Giovanna Franca Fanelli, Sara Gabbiadini and 16 more

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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26 authors.

Serena Pellegrin *Child Neurology and Rehabilitation Unit, Department of Pediatrics, Provincial Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University, Bolzano-Bozen, Italy. serena.pellegrin@sabes.it.ORCID http://orcid.org/0000-0001-9954-3053
Massimo Mastrangelo *Pediatric Intensive Care Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Patrizia AccorsiUnit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
Susanna CasellatoChild Neuropsichiatry, Department of Woman' and Child's Health, Unit of Pediatric Epilepsies, AOU Sassari University, Sassari, Italy.
Elisabetta CesaroniChild Neurology and Psychiatric Unit, G. Salesi Pediatric Hospital, Azienda Ospedaliera-Universitaria delle Marche, Ancona, Italy.
Lucrezia De CosmoNeonatology and Neonatal Intensive Care Unit, Central Hospital "SS. Annunziata", Taranto, Italy.
Paola De LisoManagement and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Robertino DilenaClinical Neurophysiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Giovanna Franca FanelliNeurophysiology Unit, IRCCS S. Raffaele, Milan, Italy.
Sara GabbiadiniUnit of Child Neuropsychiatry, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Gaia Alessandra KullmannFondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Silvia LoriNeurophysiology Unit, Neuro-Musculo-Skeletal Department, AOU Careggi University, Firenze, Italy.
Licia LugliNeonatology Unit, Maternal and Child Department, University Hospital of Modena, Modena, Italy.
Maria Margherita MancardiUnit of Child Neuropsychiatry, IRCCS Gaslini (full member of the European Network, EpiCARE), Genova, Italy.
Sara MatricardiChild Neurology and Psychiatric Unit, G. Salesi Pediatric Hospital, Azienda Ospedaliera-Universitaria delle Marche, Ancona, Italy.
Francesco PisaniChild Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University, Rome, Italy.
Dario PrunaChild Neurology and Epileptology Unit, Pediatric Department, ARNAS Brotzu, Cagliari, Italy.
Stefano SartoriPediatric Neurology and Neurophysiology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
Federica TeutonicoChildhood and Adolescence Neurology & Psychiatry Unit, ASST Grande Ospedale Metropolitano Niguarda, Department of Health Sciences, University of Milan, Milan, Italy.
Irene ToldoPediatric Neurology and Neurophysiology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.
Raffaella VergaroChild and Adolescence Neuropsychiatry Unit, CNPIA Vignola, Ausl Modena, Modena, Italy.
Aglaia VignoliChildhood and Adolescence Neurology & Psychiatry Unit, ASST Grande Ospedale Metropolitano Niguarda, Department of Health Sciences, University of Milan, Milan, Italy.
Roberta VittoriniChild Neurology Unit, Children Hospital "Regina Maergherita", A.O.U. Città della Salute e della Scienza - Torino, Turin, Italy.
Bernardo Dalla BernardinaCenter for Research on Epilepsy in Pediatric age (CREP), University Hospital of Verona, Verona, Italy.
Maria Roberta CilioInstitute of Neuroscience (IoNS), Université Catholique de Louvain, Brussels, Belgium; Division of Pediatric Neurology, Department of Pediatrics, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Gaetano CantalupoCenter for Research on Epilepsy in Pediatric age (CREP), University Hospital of Verona, Verona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberous Sclerosis Complex (TSC) is a multisystem human genetic disorder frequently associated with early-onset epilepsy. Neonatal seizures are increasingly recognized. Detailed neonatal electroclinical characterization remains limited.

methodsWe conducted a multicentre retrospective study across 16 Italian centres, including 32 neonates (term and preterm) with definitive diagnosis of TSC and at least one EEG- or video-EEG-confirmed seizure during neonatal period. Seizure semiology, EEG features, clinical variables were systematically reviewed and analysed.

resultsNeonatal seizures were recorded at a mean postnatal age of 8.7 ± 9.9 SD days and a mean postmenstrual age of 39.4 weeks, significatively earlier in preterm VS term newborns (respectively 36,5 ± 1,7 SD and 40,4 ± 1,9 SD; p < .001). Electrographic-only seizures were the most frequent, reported in 58%. Status epilepticus was recorded in 31% of neonates. Interictal EEG abnormalities were present in 83% of infants, while in 17%, seizures occurred without preceding interictal discharges. TSC2 was the predominant gene involved (93%).

conclusionEpilepsy in TSC may present in neonatal period as electrographic-only seizures, including status epilepticus, and may occur before term age. This underscores the importance of early EEG monitoring -even in asymptomatic neonates with suspected or confirmed TSC- to enable timely diagnosis and intervention. IMPACT: The study shows that neonatal‑onset epilepsy is a key early manifestation of TSC, often presenting as electrographic‑only seizures and sometimes as status epilepticus, especially in infants with TSC2 variants. It adds a detailed multicentre electroclinical description demonstrating that seizures may occur before term age, are frequently clinically silent, and interictal epileptic discharges are not always present at seizure onset. It highlights the need for early EEG monitoring in all neonates with suspected or confirmed TSC, to enable timely detection of seizures and intervention.

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