Seizures in 3-month-old infant when placed on stomach

Differentiation between seizures and non‐epileptic phenomena in neonates and young infants can be challenging, particularly when the electroencephalogram (EEG) is normal. The history may suggest recurrent seizures, but typically, in the non‐epileptic events, there is no response to the usual anticonvulsants, even in combination.

The capacity to induce or curtail rhythmic movements or tonic postures by physical manoeuvres is a useful guide to differentiate seizures from non‐epileptic events. Well‐recognised non‐epileptic motor phenomena include tremor, jitteriness and sleep myoclonus.1 We report an infant with frequent tonic spasms from soon after birth, which were unresponsive to multiple anticonvulsants but did respond promptly to medication once the diagnosis was recognised.