Levetiracetam treatment for neonatal intractable seizure / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the efficacy and safety of Levertiracetam (LEV) in treating the neonates with intractable seizure, those who had under gone failed Phenobarbital (PB) treatment previously switched to or added LEV treatment currently.Methods Totally 14 neonates,designed as intractable seizure by clinical data and video electroencephalography(VEEG) and failed to PB treatment were enrolled in the study, and all neonates were switched to LEV or LEV + PB treatment.The initial loading dose of LEV was 30 mg/kg, followed by 15 mg/kg twice a day if symptoms were controlled 8-12 h,if not, followed by 30 mg/kg once.All neonates were switched to LEV monotherapy after the symptoms were controlled 48-72 h,if the symptoms could not be controlled by combined therapy of PB and LEV after 72 h, other therapies were administered.Electrocardiogram breath synchronous monitoring was performed during the first 72 h treatment.VEEG was performed during 1-3 months follow-up.Results (1) The symptoms of 8 (57.14％) out of 14 cases were completely controlled,2 neonates(14.29％) reduced seizure more than 50％ ,4 neonates(28.57％) failed to LEV or LEV + PB treatment,as a result,all of those neonates were switched to other treatments.(2) No drug adverse effect was observed.(3) One neonate died of hypoxic-ischemic encephalopathy combined with multiple organ failure during follow-up period, 7 cases were seizure-free with normal VEEG, 5 cases were switched to or added other antiepileptic drugs because of uncontrolled symptoms, and one neonate discontinued the follow-ups.Conclusions The high efficiency and safety of LEV for the treatment of the newborn seizures were proved by small samples of patients.And currently there is no evidence to prove PB might increase neuronal excessive apoptosis of the brain and the cognitive impairment, and more clinical researches are needed to promote LEV as a gleam of rescue medications of neonatal seizure as soon as possible.