Title: Efficacy of Levetiracetam as first-line treatment in neonatal seizure

Authors: Anup Kumar, Anil Kumar Jaiswal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.140

Abstract

Background: Appropriate treatment of neonatal seizures is important in reducing long-term neurologic disabilities. In our NICU, the first-line anti-seizure medication for the treatment of neonatal seizures is phenobarbitone (PB).The purpose of this study is to evaluate the efficacy of levetiracetam (LEV) as 1stline treatment in neonatal seizures.

Materials and Methods: This study was conducted in neonates admitted in Neonatal Intensive Care Unit of Patna Medical College and Hospital, Patna, Bihar from July 2017 to December 2017. 20 neonates with clinical convulsions were enrolled in the study and received IV LEV at standard doses.

Results: 65 % of neonates responded to IVLEV treatment, at the end of 1stweek. Other neonates required additional anticonvulsant therapy like phenobarbitone, phenytoin. No major side-effects of LEV were noted.

Conclusions: LEV is effective as 1stline treatment in neonatal seizures.

Keywords: Efficiency and safety, levetiracetam, neonatal seizures, prospective study.

References

  1. Stafstrom CE. Neonatal seizures. Pediatr Rev 1995;16:248–255.
  2. Painter MJ, Scher MS, Stein AD, Armatti S, Wang Z, Gardiner JC, et al. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med 1999;341:485-9.     
  3. Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, et al.Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE commission on classification and terminology, 2005-2009. Epilepsia 2010;51:676-85. 
  4. Calandre EP, Dominguez-Granados R, Gomez-Rubio M, Molina-Font JA. Cognitive effects of long-term treatment with phenobarbital and valproic acid in school children. Acta NeurolScand 1990;81:504-6.    
  5. Maitre NL, Smolinsky C, Slaughter JC, Stark AR. Adverse neurodevelopmental outcomes after exposure to phenobarbital and levetiracetam for the treatment of neonatal seizures. J Perinatol 2013;33:841-6.  
  6. Dilena R, Striano P, Traverso M, Viri M, Cristofori G, Tadini L, et al.Dramatic effect of levetiracetam in early-onset epileptic encephalopathy due to STXBP1 mutation. Brain Dev 2016;38:128-31.  
  7. Mruk AL, Garlitz KL, Leung NR. Levetiracetam in neonatal seizures: A review. J Pediatr Pharmacol Ther 2015;20:76-89.   
  8. Loiacono G, Masci M, Zaccara G, Verrotti A. The treatment of neonatal seizures: Focus on levetiracetam. J MaternFetal Neonatal Med 2016;29:69-74.  
  9. Silverstein FS, Ferriero DM. Off-label use of antiepileptic drugs for the treatment of neonatal seizures. Pediatr Neurol 2008;39:77-9.     
  10. Khan O, Chang E, Cipriani C, Wright C, Crisp E, Kirmani B. Use of intravenous levetiracetam for management of acute seizures in neonates. Pediatr Neurol 2011;44:265-9. 
  11. Abend NS, Gutierrez. Colina AM, Monk HM, Dlugos DJ, Clancy RR. Levetiracetam for treatment of neonatal seizures. J Child Neurol 2011;26:465.70.
  12. Riis P. Perspectives on the fifth revision of the Declaration of Helsinki. JAMA 2000;284:3045.6.
  13. Pisani F, Barilli AL, Sisti L, Bevilacqua G, Seri S. Preterm infants with video.EEG confirmed seizures: Outcome at 30 months of age. Brain Dev 2008;30:20.30.
  14. Ramantani G, Ikonomidou C, Walter B, Rating D, Dinger J. Levetiracetam: Safety and efficacy in neonatal seizures. Eur J PaediatrNeurol 2011;15:1.7.
  15. Yau ML, Fung EL, Ng PC. Response of levetiracetam in neonatal seizures. World J ClinPediatr 2015;4:45.9.
  16. Perveen S, Singh A, Upadhyay A, Singh N, Chauhan R. A randomized controlled trial on comparison of phenobarbitone and levetiracetam for the treatment of neonatal seizures: pilot study. Int J Res Med Sci 2016;4:2073-8.
  17. Kirmani BF, Crisp ED, Kayani S, Rajab H. Roleof Intravenous Levetiracetam in Acute SeizureManagement of Children.Pediatric Neurology2009; 41(1): 37-9.

Corresponding Author

Dr Anup Kumar

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