Media devices (MD) are widespread today not only among adults, as also pre-school children are growing up in environments fool of internet connections, personal computer and video games. The percentage of children aged 0–8 years using a mobile device increased from 38% in 2011 to 72% in 2013 [
122]. At present, almost all children use MD, most of kids start using a mobile MD before the age of 1 year, and a lot of them use a device daily, in particular smartphones and tablets [
123]. Several studies have described the adverse effects of an early and prolonged exposure of pre-school children to digital technology, underlining the negative effects on the neurocognitive development, learning, well-being, sight and listening [
124]. Bozzola et al. have investigated both beneficial and negative effects of media on pre-school children’s mental and physical health [
125]. They found that touch screen usage may interfere with infant and toddler learning development. However, children younger than 3 years old can learn words through video if the experimenter/parent/caregiver provide additional verbal and non-verbal information during the live action sequences [
126]. Moreover, mobile phones could reinforce what children are already learning at school. As far as children’s development, it is negatively affected by the television exposure [
127], while drawing apps are appropriate for young children playing a positive role in their development [
128]. MD inappropriate use is also associated to behavioral problems, obesity, sedentary, and physical discomfort, especially involving neck and shoulders [
129]. Media usage may also interfere with sleep quality, in particular the presence of a television in the bedroom is associated with sleep terrors, nightmares and sleep talking [
130]. Excessive smartphone use at a close reading distance might induce ocular fatigue, glare, and irritation and be responsible for acute exotropia [
131]. Speech and language development may be compromised too. Difficulties in socializing, communicating and interacting with other kids and parents may be possible side effects [
132]. Paediatrician and families should create a network to manage MD to minimize unhealthy habits and behaviors, avoiding negative effects on health, wellness, social and personal development [
133]. Finally, in agreement with the American Academy of Pediatrics [
123] and the Australian guidelines [
134], media devices should not be used in children under 2 years of age. Media exposure should be limited to less than 1 h per day in children aged 2–5 years, to less than 2 h per day in children aged 5–8 years, to high-quality programming, just in presence of an adult, and to apps tested by a care-giver before the child usage.
Social media has had a profound effect on how children and adolescents interact. While there are many benefits to the use of social media, cyberbullying is now well recognized as a serious public health problem affecting children and adolescents [
135]. It is defined as “any behavior performed through electronic or digital media by individuals or groups that repeatedly communicates hostile or aggressive messages intended to inflict harm or discomfort on others” [
136]. Ferrara et al. have recently reviewed the data available in the literature about these rising phenomena [
137]. Actually, 20 to 40% of children and adolescents have been victims of cyberbullying, with females and sexual minorities seemingly at higher risk. The most common methods for electronic bullying involve the use of instant messaging, chat rooms, and e-mail. Importantly, in most cases the electronic bully victims do not know the perpetrator’s identity, indeed anonymity, by promoting disinhibition, can lead to magnified aggression because the perpetrator may feel out of reach and immune to retribution. In this context, adolescents’ levels of social and emotional development leave them vulnerable to peer pressure and at the same time adolescents’ capacity to self-regulate is limited, generally they realize the severity of the situation after the effects have already occurred [
138]. The motivation behind cyberbullying seems to be lack of confidence or the desire to feel better about themselves, a desire for control, finding it entertaining and retaliation, moreover there is a relation between cyberbullying and internet addiction. In cyberbullying, differently of traditional bullying, aggressive behaviors occur at any given time of the day, therefore the persistence of the bullying behaviors may result in even stronger negative outcomes than traditional bullying [
136,
138]. Cyberbullying could lead to new onset psychological symptoms, somatic symptoms of unclear aetiology or a drop in academic performance. It seems to be that victims of cyberbullying have lower self-esteem, higher levels of depression, behavioral problems, substance abuse and experience significant life challenges [
136,
138] which could result in suicidal behavior. Ferrara et al. between January 2011 and December 2013 identified 55 cases of suicide among Italian children and young adults aged less than18-years, and found that the second most frequent known cause of suicide is bullying [
139]. In Italy, 2015 ISTAT data show that, among the media devices adolescent users, the 5.9% report being victims of cyberbullying [
140]. As several suicides were linked to cyberbullying, the Italian Parliament has approved the so-called “anti-cyberbullying law” which makes it illegal to use the Internet to offend, slander, threaten or steal the identity of a minor, and ensure victims and their parents to demand that websites hosting abusive content is removed within 48 h [
141]..
Seizures are not uncommon clinical manifestations in childhood. The term epilepsy defines the recurrences of two or more unprovoked seizures. Seizures starting in the first year of life including the neonatal period might have a favorable course, such as in infants presenting with Benign Familial Neonatal Epilepsy (BFNE), Febrile Seizures simplex (FSs) and Acute Symptomatic Seizures (ASS). However, in some cases, the onset of seizures at birth or in the first months of life have a dramatic evolution with severe cerebral impairment such as “epileptic encephalopathies”.
Pavone et al. provided an updated review of the conditions associated with seizures in the first year of life [
142]. BFNE is a condition inherited as an autosomal dominant trait (mutation in the KCN gene, chromosome 20q13.33) and is characterized by seizures in the first days of life in otherwise healthy looking babies and are typically associated with a family history of neonatal seizures, neonatal prognosis is usually benign and the seizures tend to gradually disappear within the first months of life [
143]. ASS is defined as a clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult [
144], they might follow trauma, intoxication, or anomalous administration of drugs or they could be induced by electrolytic dysregulation (acute hypoglycemia, hypocalcemia, and hyponatremia). The occurrence of the ASS is particularly high in the infantile period since, at this age the brain seems to be more susceptible to such insults. The seizures present most frequently as motor tonic-clonic generalized types and they usually have benign course. FS are the most common convulsive manifestations in childhood, FSs are defined as a short (< 15 min.) generalized seizures, not recurring within 24 h which occur during a febrile illness not resulting from an acute disease of the nervous system, in a child aged between 6 months and 5 years, with no neurologic deficits and no previous afebrile seizures [
145]. Intravenous, intramuscular, buccal, intranasal or rectal benzodiazepines are administered to stop the crises while prophylactic pharmacologic treatment is not advised [
146].
Febrile Seizures complex (FSc) are focal, or generalized, and prolonged seizures lasting more than 15 min, recurrence can happen within 24 h in the course of the same febrile episode, the temperature might not be elevated. Moreover, the crises might be associated with post-ictal neurologic abnormalities, most frequently post-ictal palsy, or manifest in subjects with previous neurologic deficits. They might be present in alternation with afebrile seizures, or in members of a family affected by Genetic Epilepsy with Febrile Seizures plus (GEFS+, autosomal dominant disorder characterized by mutations of the gene SCN2A or less frequently of SCN1B) [
147]. Febrile status epilepticus might also be recorded. The acute treatment is based on the use of benzodiazepines. In FSc, prophylactic treatment might be useful in reducing the frequency and the duration of the crises but is not considered able to prevent the onset of subsequent epileptic seizures [
148].