GiriNeoSeizure™ CDSS — Neonatal Seizures: Stabilise, Confirm, Treat & Reassess (Edition 1, Version 2.0)
Abstract
GiriNeoSeizure™ CDSS is a single-file, offline, interactive clinical decision-support system for neonatal seizures. It is part of the NeonatAIlogy™ series in the GAIR Innovation Registry and is governed by the GIRISH™ Prompting Architecture. The tool turns the 2023 ILAE Task Force guideline, Cochrane evidence on antiseizure medication and EEG accuracy, and contemporary cohorts into one bedside pathway: stabilise → confirm on EEG → treat by pattern, with sourced doses → reassess. It includes a rule-based pathway navigator (no numeric score), printable reference cards, CME vignettes, a clinician FAQ and a certainty-graded reference base. New in Version 2.0 (evidence updated to 22 September 2026): Module 4A — ASM Mechanisms of Action: a synapse target map and a drug-by-drug table covering phenobarbital, midazolam, phenytoin/fosphenytoin, carbamazepine, oxcarbazepine, levetiracetam, lidocaine, pyridoxine/PLP, topiramate, bumetanide and quinidine. It explains why GABA-enhancing drugs are weaker in the immature brain. Module 4B — Channelopathy & Precision Therapy: red flags for suspecting a channelopathy, a five-step diagnostic sequence including rapid genomics, a gene-by-function drug-selection matrix (KCNQ2, KCNQ3, SCN2A, SCN8A, KCNT1, STXBP1) with evidence grades, safety monitoring, and an adaptation for India and resource-limited settings. Module 7A — Counselling & Follow-up: four staged family conversations, the evidence behind stopping medicine before discharge, prognosis by cause, genetic counselling, a home seizure plan, a follow-up schedule to 24 months, and a discharge checklist. Updated therapy evidence (2025–26 levetiracetam-vs-phenobarbital meta-analyses, midazolam systematic review), imaging (CT de-emphasised), neonatal-encephalopathy terminology, navigator, cards, CME and FAQ. References expanded from 38 to 71. Quality assurance: a pre-release GiriIterate™ audit (DOI 10.5281/zenodo.22657122) was run. It covered 28 quality domains, redundancy, claim-and-citation verification and 432 navigator test cases. Status: conditionally ready, with independent pharmacist and neonatal-neurology sign-off recorded as outstanding in an in-tool ledger. The audit report is included as a supplementary file. Safety and governance: this is a Supportive Risk Signal, not a directive. It is an educational reference and does not replace clinical judgement. No dose was changed from Version 1.0. No neonatal carbamazepine, oxcarbazepine, quinidine or lidocaine dose is printed, by design. Confirm all doses against your unit's pharmacy-verified formulary. AI disclosure: drafted with Claude (Anthropic). Literature discovery was assisted by Consensus AI and the PubMed connector, used as discovery aids and not as evidence sources. The author reviewed and is accountable for all content.
