Response to antiseizure medications in neonates with acute symptomatic seizures

• Published in: Epilepsia (Copenhagen) Vol. 60; no. 3; pp. e20 - e24
• Main Authors: Glass, Hannah C., Soul, Janet S., Chu, Catherine J., Massey, Shavonne L., Wusthoff, Courtney J., Chang, Taeun, Cilio, Maria Roberta, Bonifacio, Sonia L., Abend, Nicholas S., Thomas, Cameron, Lemmon, Monica, McCulloch, Charles E., Shellhaas, Renée A.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2019
• Subjects: AED; Anticonvulsants - therapeutic use; antiepileptic drug; Brain - physiopathology; Convulsions & seizures; Drug therapy; electroencephalogram; Electroencephalography; Encephalopathy; epilepsy; Female; Gestational age; Hemorrhage; Humans; Hypothermia; Hypoxia; hypoxic‐ischemic encephalopathy; Infant, Newborn; Infant, Newborn, Diseases - drug therapy; Infant, Newborn, Diseases - physiopathology; Ischemia; Male; neonatal encephalopathy; neonatal seizures; Neonates; neurocritical care; Prospective Studies; seizure; Seizures; Seizures - drug therapy; Seizures - physiopathology; Treatment Outcome; AED; epilepsy; seizure; antiepileptic drug; hypoxic-ischemic encephalopathy; neonatal encephalopathy; neonatal seizures; electroencephalogram; neurocritical care
• ISSN: 0013-9580; 1528-1167; 1528-1167
• DOI: 10.1111/epi.14671

Summary In a prospective cohort of 534 neonates with acute symptomatic seizures, 66% had incomplete response to the initial loading dose of antiseizure medication (ASM). Treatment response did not differ by gestational age, sex, medication, or dose. The risk of incomplete response was highest for seizures due to intracranial hemorrhage and lowest for hypoxic‐ischemic encephalopathy, although the difference was not significant after adjusting for high seizure burden and therapeutic hypothermia treatment. Future trial design may test ASMs in neonates with all acute symptomatic seizure etiologies and could target neonates with seizures refractory to an initial ASM.