Neonatal Seizure Management: Is the Timing of Treatment Critical?
J Pediatr
; 243: 61-68.e2, 2022 04.
Article
en En
| MEDLINE
| ID: mdl-34626667
ABSTRACT
OBJECTIVE:
To assess the impact of the time to treatment of the first electrographic seizure on subsequent seizure burden and describe overall seizure management in a large neonatal cohort. STUDYDESIGN:
Newborns (36-44 weeks of gestation) requiring electroencephalographic (EEG) monitoring recruited to 2 multicenter European studies were included. Infants who received antiseizure medication exclusively after electrographic seizure onset were grouped based on the time to treatment of the first seizure antiseizure medication within 1 hour, between 1 and 2 hours, and after 2 hours. Outcomes measured were seizure burden, maximum seizure burden, status epilepticus, number of seizures, and antiseizure medication dose over the first 24 hours after seizure onset.RESULTS:
Out of 472 newborns recruited, 154 (32.6%) had confirmed electrographic seizures. Sixty-nine infants received antiseizure medication exclusively after the onset of electrographic seizure, including 21 infants within 1 hour of seizure onset, 15 between 1 and 2 hours after seizure onset, and 33 at >2 hours after seizure onset. Significantly lower seizure burden and fewer seizures were noted in the infants treated with antiseizure medication within 1 hour of seizure onset (P = .029 and .035, respectively). Overall, 258 of 472 infants (54.7%) received antiseizure medication during the study period, of whom 40 without electrographic seizures received treatment exclusively during EEG monitoring and 11 with electrographic seizures received no treatment.CONCLUSIONS:
Treatment of neonatal seizures may be time-critical, but more research is needed to confirm this. Improvements in neonatal seizure diagnosis and treatment are also needed.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Estado Epiléptico
/
Epilepsia
/
Enfermedades del Recién Nacido
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
Límite:
Humans
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Infant
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Newborn
Idioma:
En
Año:
2022
Tipo del documento:
Article