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Despite there being many randomised controlled trials (RCTs) of anticonvulsants in children and adults, there are only two RCTs directly comparing anticonvulsants in neonatal seizures.1 2 Acknowledging this inequality, the James Lind Alliance has highlighted neonatal seizures treatments as a top research priority.3 Why so few trials exist is an important question. One explanation may be the recommendation that continuous multichannel electroencephalogram (cEEG) should be the outcome measure of choice because of its superior detection rates compared with amplitude integrated EEG (aEEG).4 This is important because most neonatal seizures are electrographic and over-diagnosis of seizures in response to other movements is common. While scientifically justified, cEEG is not available or interpretable at all hours of the day in all UK Neonatal Units.