Response to antiseizure medications in neonates with acute symptomatic seizures

Epilepsia. 2019 Mar;60(3):e20-e24. doi: 10.1111/epi.14671. Epub 2019 Feb 20.

Abstract

In a prospective cohort of 534 neonates with acute symptomatic seizures, 66% had incomplete response to the initial loading dose of antiseizure medication (ASM). Treatment response did not differ by gestational age, sex, medication, or dose. The risk of incomplete response was highest for seizures due to intracranial hemorrhage and lowest for hypoxic-ischemic encephalopathy, although the difference was not significant after adjusting for high seizure burden and therapeutic hypothermia treatment. Future trial design may test ASMs in neonates with all acute symptomatic seizure etiologies and could target neonates with seizures refractory to an initial ASM.

Keywords: AED; antiepileptic drug; electroencephalogram; epilepsy; hypoxic-ischemic encephalopathy; neonatal encephalopathy; neonatal seizures; neurocritical care; seizure.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Brain / physiopathology
  • Electroencephalography
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / drug therapy*
  • Infant, Newborn, Diseases / physiopathology
  • Male
  • Prospective Studies
  • Seizures / drug therapy*
  • Seizures / physiopathology
  • Treatment Outcome

Substances

  • Anticonvulsants