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Second-line anticonvulsant treatment of neonatal seizures: a video-EEG monitoring study

G B Boylan1, J M Rennie, G Chorley

  • 1Department of Child Health, Guy's King's St Thomas' School of Medicine, London, UK. g.boylan@ucc.ie

Neurology
|February 12, 2004
PubMed

Insights

Phenobarbitone effectively treated neonatal seizures, but second-line treatments like lignocaine and benzodiazepines showed limited success. Poor neurodevelopmental outcomes were observed in infants treated with benzodiazepines.

Area of Science:

  • Neonatal neurology
  • Clinical pharmacology

Background:

  • Neonatal seizures are challenging to diagnose clinically.
  • Reliable assessment requires electroencephalography (EEG).

Purpose of the Study:

  • To evaluate second-line anticonvulsant treatments for neonatal seizures.
  • To assess treatment efficacy using continuous video-EEG.

Main Methods:

  • Randomized trial of neonates with EEG-confirmed seizures.
  • First-line treatment: phenobarbitone (40 mg/kg).
  • Second-line treatments: lignocaine and benzodiazepines.

Main Results:

  • 11 of 27 neonates responded to phenobarbitone.
  • 3 of 5 neonates responded to lignocaine.
  • No neonates responded to benzodiazepines; poor neurodevelopmental outcomes were noted.

Conclusions:

  • Phenobarbitone is an effective first-line treatment for neonatal seizures.
  • Lignocaine shows limited efficacy as a second-line option.
  • Benzodiazepines appear ineffective and associated with poor outcomes in this neonatal population.

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