Comparison of the neurocognitive outcomes in term infants treated with levetiracetam and phenobarbital monotherapy for neonatal clinical seizures

Seizure. 2020 Aug:80:71-74. doi: 10.1016/j.seizure.2020.06.006. Epub 2020 Jun 5.

Abstract

Purpose: This study aims to compare the neurocognitive outcome in term infants who were treated using phenobarbital (PB) and levetiracetam (LEV) monotherapy for neonatal clinical seizures.

Methods: Term infants who were treated using PB or LEV monotherapy as the first-line anti-epileptic treatment for neonatal clinical seizures and followed-up in a pediatric neurology outpatient clinic were enrolled in this study. Neurodevelopmental outcome assessments were carried out using the Bayley Scales of Infant Development, third edition (BSID-III), including cognitive, receptive language, expressive language, fine motor and gross motor subscales.

Results: The study group consisted of 62 infants who received monotherapy with PB monotherapy (n = 22) and LEV (n = 40). The mean duration of monotherapy treatment was 8 ± 6 months. There was no statistically significant difference between PB and LEV monotherapy groups concerning each outcome parameter on the BSID-III. There was also no statistically significant difference between PB and LEV monotherapy subgroups excluding the infants with neurodevelopmental impairment with a BSID-III scale score<7 or a composite score<85.

Conclusion: Our findings suggest that both LEV and PB therapy can be equally safe as monotherapy for neonatal clinical seizures for the neurodevelopmental outcome assessment with BSID-III.

Keywords: Infant; Monotherapy; Neonatal; Neurodevelopment; Seizure.

MeSH terms

  • Anticonvulsants / therapeutic use
  • Child
  • Epilepsy* / drug therapy
  • Humans
  • Infant
  • Infant, Newborn
  • Levetiracetam / therapeutic use
  • Phenobarbital* / therapeutic use
  • Seizures / drug therapy

Substances

  • Anticonvulsants
  • Levetiracetam
  • Phenobarbital