Prophylactic antiseizure medication administration practices in neonates with hypoxic-ischaemic encephalopathy: a
Lillian Edith Nalwanga1, Innocent Ayesiga2, Tom Didimus Ediamu3
1Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
Insights
This review examines the use of antiseizure medications to prevent seizures in newborns with hypoxic-ischaemic encephalopathy (HIE). It aims to clarify evidence on prophylactic treatment for HIE neonates, addressing controversial practices.
Area of Science:
- Neonatal Neurology
- Neurocritical Care
- Evidence Synthesis
Background:
- Hypoxic-ischaemic encephalopathy (HIE) is a major cause of neonatal death and disability.
- Neonatal seizures are frequent in HIE and linked to poor outcomes.
- Prophylactic antiseizure medication use in HIE neonates without clinical seizures is debated.
Purpose of the Study:
- To map existing evidence on prophylactic antiseizure medication use in neonates with HIE.
- To address the controversy and variable practices surrounding prophylactic treatment.
- To provide a comprehensive overview of current research.
Main Methods:
- Scoping review following Joanna Briggs Institute methodology.
- Reporting according to PRISMA-ScR guidelines.
- Comprehensive literature search across PubMed, Embase, Scopus, Web of Science.
Main Results:
- The review will synthesize findings on prophylactic antiseizure medication use in HIE.
- It will identify gaps and trends in the current evidence base.
- Results will be organized using Covidence for screening and data extraction.
Conclusions:
- This review will clarify the evidence base for prophylactic antiseizure medication in HIE.
- Findings will inform clinical practice and future research directions.
- Results will be disseminated through publication and a public data repository.
Introduction:
Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of neonatal mortality and long-term neurodevelopmental impairment worldwide. Neonatal seizures are common in HIE and are associated with adverse outcomes. While antiseizure medications are routinely used for treatment, their prophylactic use in the absence of clinically evident seizures remains controversial, with limited consensus and variable clinical practices. Therefore, this review will map the existing evidence concerning the utilisation of antiseizure medication for prophylaxis among neonates with HIE.
Methods And Analysis:
The review will follow the Joanna Briggs Institute scoping review methodology and be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search will be conducted across various scientific databases, including PubMed, Embase, Scopus and Web of Science, guided by the Population, Intervention, Concept and Context framework, starting between October and November 2026. The review will consider studies on the prophylactic use of antiseizure medication among neonates with HIE. The collected search results will be organised and uploaded to Covidence, where duplicates will be removed, and titles and abstracts will be screened. Search and screening processes have not yet started.
Ethics And Dissemination:
This will be a secondary study using already published information; therefore, ethical approval was not sought. All studies included in this review will be cited accordingly, as attributed to the publication licence. The data gathered will be summarised in a scoping review and submitted for publication in an international peer-reviewed journal. Datasets shall also be made publicly available in a data repository, such as the Open Science Framework.
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