eonates and infants may exhibit a wide variety of paroxysmal episodes that markedly differ from those encountered in older children and adults. These differences relate to the immaturity of the nervous system, which impacts upon the nature of the paroxysmal attacks in several ways. Neonates and infants are more susceptible to imbalances in autonomic control and may, for example, have apnea and syncope spontaneously, or in response to minor provocation. The repertoire of possible movements is constrained, so complex paroxysmal attacks, like paroxysmal dyskinesias, are rarely seen. At the same time, the simplicity and subtlety of paroxysmal attacks may make it especially difficult to differentiate nonepileptic from epileptic paroxysmal events. It is useful to keep in mind the common manifestations of epileptic seizures in neonates and infants when considering nonepileptic paroxysmal events. A brief summary of the semeiology of ictal events will follow.
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