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Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures

OBJECTIVE: Seizure is the most common signs of nervous system disease in neonates. The first line of treatments in neonatal seizures (after ruling out and emergency treatment of electrolyte imbalance and hypoglycemia) are phenobarbital and phenytoin. We aimed to evaluate drugs that are more effectiv...

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Autores principales: MOLLAMOHAMMADI, Mohsen, AMIRHOSEINI, Zeinab Sadat, SAADATI, Alireza, PIRZADEH, Zahra, HASSAN AMOUZADEH, Masoud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shahid Beheshti University of Medical Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160636/
https://www.ncbi.nlm.nih.gov/pubmed/30279713
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author MOLLAMOHAMMADI, Mohsen
AMIRHOSEINI, Zeinab Sadat
SAADATI, Alireza
PIRZADEH, Zahra
HASSAN AMOUZADEH, Masoud
author_facet MOLLAMOHAMMADI, Mohsen
AMIRHOSEINI, Zeinab Sadat
SAADATI, Alireza
PIRZADEH, Zahra
HASSAN AMOUZADEH, Masoud
author_sort MOLLAMOHAMMADI, Mohsen
collection PubMed
description OBJECTIVE: Seizure is the most common signs of nervous system disease in neonates. The first line of treatments in neonatal seizures (after ruling out and emergency treatment of electrolyte imbalance and hypoglycemia) are phenobarbital and phenytoin. We aimed to evaluate drugs that are more effective on neonatal seizure. MATERIALS & METHODS: Patients admitted to neonatal wards & NICUs (level   IIa&  IIb) in Qom hospitals (2015-2017), central Iran with presentation of seizure, were enrolled in this clinical trial study. After ruling out electrolyte imbalance and hypoglycemia these neonates were managed by intravenous phenobarbital, then if no response was seen we added intravenous phenytoin and for remaining neonates with refractory seizure we applied oral levetiracetam as add on therapy. The study was registered as code number of IRCT2016051527896N1. RESULTS: Initially, 245 neonates were enrolled. According to exclusion criteria, 12 cases were excluded, and phenobarbital was prescribed to the remaining patients. Out of these, 86 patients did not respond, and phenytoin was prescribed for them. Forty two patients who were not responding to phenytoin were finally treated with oral levetiracetam. Finally, 95.3% of seizures were controlled with oral levetiracetam but 4.7% were not cured. CONCLUSION: When the intravenous form of levetiracetam is not available and neonatal seizure does not respond to first line classic drugs, oral levetiracetam as add on therapy maybe effective.
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spelling pubmed-61606362019-01-01 Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures MOLLAMOHAMMADI, Mohsen AMIRHOSEINI, Zeinab Sadat SAADATI, Alireza PIRZADEH, Zahra HASSAN AMOUZADEH, Masoud Iran J Child Neurol Original Article OBJECTIVE: Seizure is the most common signs of nervous system disease in neonates. The first line of treatments in neonatal seizures (after ruling out and emergency treatment of electrolyte imbalance and hypoglycemia) are phenobarbital and phenytoin. We aimed to evaluate drugs that are more effective on neonatal seizure. MATERIALS & METHODS: Patients admitted to neonatal wards & NICUs (level   IIa&  IIb) in Qom hospitals (2015-2017), central Iran with presentation of seizure, were enrolled in this clinical trial study. After ruling out electrolyte imbalance and hypoglycemia these neonates were managed by intravenous phenobarbital, then if no response was seen we added intravenous phenytoin and for remaining neonates with refractory seizure we applied oral levetiracetam as add on therapy. The study was registered as code number of IRCT2016051527896N1. RESULTS: Initially, 245 neonates were enrolled. According to exclusion criteria, 12 cases were excluded, and phenobarbital was prescribed to the remaining patients. Out of these, 86 patients did not respond, and phenytoin was prescribed for them. Forty two patients who were not responding to phenytoin were finally treated with oral levetiracetam. Finally, 95.3% of seizures were controlled with oral levetiracetam but 4.7% were not cured. CONCLUSION: When the intravenous form of levetiracetam is not available and neonatal seizure does not respond to first line classic drugs, oral levetiracetam as add on therapy maybe effective. Shahid Beheshti University of Medical Sciences 2018 /pmc/articles/PMC6160636/ /pubmed/30279713 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
MOLLAMOHAMMADI, Mohsen
AMIRHOSEINI, Zeinab Sadat
SAADATI, Alireza
PIRZADEH, Zahra
HASSAN AMOUZADEH, Masoud
Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title_full Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title_fullStr Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title_full_unstemmed Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title_short Oral Levetiracetam as Add-On Therapy in Refractory Neonatal Seizures
title_sort oral levetiracetam as add-on therapy in refractory neonatal seizures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160636/
https://www.ncbi.nlm.nih.gov/pubmed/30279713
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