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Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
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Neonatal Antiepileptic Medication Treatment Patterns: A Decade of Change

Vi T Le1, Hibo H Abdi1, Pablo J Sánchez1,2,3,4

  • 1Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.

American Journal of Perinatology
|October 11, 2019
PubMed

Insights

Phenobarbital use for neonatal seizures decreased, while levetiracetam use increased significantly. Further research is needed to confirm levetiracetam

Area of Science:

  • Neonatal neurology and pharmacology.
  • Pediatric seizure management.
  • Clinical epidemiology of neonatal care.

Background:

  • Neonatal seizures are a critical concern requiring prompt and effective treatment.
  • Anticonvulsant medications are the cornerstone of neonatal seizure management.
  • Understanding trends in anticonvulsant use is vital for optimizing care.

Purpose of the Study:

  • To determine the frequency and characteristics of anticonvulsant medication initiation in neonates.
  • To analyze trends in the use of specific anticonvulsant drugs during the neonatal period.
  • To identify factors associated with anticonvulsant administration in newborns.

Main Methods:

  • Analysis of a cohort of neonates diagnosed with seizures, discharged between 2007 and 2016.
  • Utilized data from the Pediatric Health Information System.
  • Modified Poisson regression was employed to calculate adjusted risk ratios for anticonvulsant initiation.

Main Results:

  • A significant decrease in phenobarbital initiation and continuation was observed.
  • Levetiracetam initiation and continuation rates markedly increased during the study period.
  • Neonates with intraventricular hemorrhage, stroke, or hypoxic ischemic encephalopathy (HIE) showed higher anticonvulsant use.

Conclusions:

  • Phenobarbital remains a primary treatment for neonatal seizures, but its use is declining.
  • Levetiracetam is emerging as a significant second-line therapy for neonatal seizures.
  • Further investigation into levetiracetam's efficacy and long-term outcomes is warranted.
Abstract

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