The Impact of Anticonvulsants on Neurologic Outcomes in Neonatal Seizures / 대한주산의학회잡지

ABSTRACT

PURPOSE: Although neonatal seizures can cause epilepsy, neurodevelopmental disability, and mortality with high frequency, the use of anti-epileptic drug is limited and the side effect of the drug is unidentified. Thus, authors investigated the prognosis of the neonatal seizures related with anti-epileptic drugs and electroencephalography. METHODS: Retrospective medical records of 37 infants with neonatal seizures under 44 weeks of gestational age who were hospitalized at neonatal intensive care unit in Seoul St. Mary' Hospital from January to June 2012 were analyzed. RESULT: The mean gestational age was 32.5+/-1.9 weeks and the mean birth weight was 2,010+/-82 g. Seizures occurred in 65% in infants within 7 days of birth and subtle seizures were most common type. Hypoxic ischemic encephalopathy was the most common cause of seizures and 62% showed abnormal electrographic findings. Among 37 of patients, seizures of 57% were able to be controlled by levetiracetam, but 19% were controlled by co-administration of more than three anti-epileptic drugs. After 6 months of treatment, epilepsy was diagnosed in 6% and developmental delay occurred in 19% among patients controlled by one anti-epileptic drug. Epilepsy and developmental delay occurred in 29% and 86%, respectively, among patients with more than three anti-epileptic drugs. In addition 86% of patients with normal electroencephalographic findings show normal development, but 3 patients with severe abnormalities showed abnormal development. CONCLUSION: Neurologic outcome was not good when the number of anti-epileptic drugs were added due to uncontrolled seizures, and the result of electroencephalography showed severe abnormalities.