As precision medicine reshapes pediatric neurology, clinicians are working to personalize treatments for children facing life-threatening neurologic crises. At the 2025 Child Neurology Society (CNS) Annual Meeting in Charlotte, Craig Press, MD, PhD, associate professor of clinical neurology at the University of Pennsylvania and medical director of the Neuroscience Unit at Children’s Hospital of Philadelphia, discussed how data-driven approaches are redefining how clinicians manage seizures, inflammation, and critical neurologic disease at the bedside.

Press presented during the session “Bringing Precision Therapy to the Neurocritical Care Bedside,” part of Seminar 7: Optimizing NeuroICU Care: Treating Patients Rather Than Seizures. The program explored novel pharmacologic and immunologic strategies—such as ketamine, ganaxolone, and cytokine-targeting therapies—and how integrating quantitative EEG and genetic testing can tailor interventions to each child’s unique etiology.

Rethinking seizure and inflammation management

“The biggest goal here was, when we think about neurocritical care and pediatric patients, there’s a lot of variety in the kids that we take care of,” Press said. “Each individual patient may respond differently to these therapeutics, or they may need a different diagnostic path.”

Press emphasized that while care pathways serve most patients, others—such as those experiencing new-onset refractory status epilepticus—require rapid diagnostics and customized intervention. “They need rapid genetic testing, and new quantitative ways of looking at their EEG in response to therapies so that we can better target the underlying causes,” he said.

Emerging therapies and challenges

Press highlighted several promising treatments under study, including anakinra, tocilizumab, and ganaxolone, noting that while ganaxolone’s recent trial did not meet all primary endpoints, “there were some exciting signals that suggest there may be ways this drug could be used.”

Key areas of innovation include:

• Expanding access to immune-targeted therapies for neuroinflammatory conditions
• Using quantitative EEG to monitor real-time treatment response
• Leveraging genetic and molecular diagnostics to refine drug selection

Building collaboration for better data

“One of the most important things we deal with in pediatrics is that therapies developed in adults often haven’t been tested in children yet. We’re trying to pull together large samples of kids to better understand responses to therapy, so we’re not just relying on correlations or individual cases to drive care,” he said.

Reference:

Press C. Bringing Precision Therapy to the Neurocritical Care Bedside. Presented at: 2025 Child Neurology Society. October 8-11. Charlotte, North Carolina.