Treatment of neonatal seizures

Semin Fetal Neonatal Med. 2013 Aug;18(4):209-15. doi: 10.1016/j.siny.2013.01.001. Epub 2013 Feb 9.

Abstract

Seizures occur more often during the neonatal period than at any other period of life. Precise incidence is difficult to delineate and depends on study population and criteria used for diagnosis of seizures. Controversy exists as to whether neonatal seizures themselves cause damage to the developing brain, or if the damage is primarily due to the underlying cause of the seizures. As a result of this controversy there is an ongoing discussion as to whether all seizures (both clinical and subclinical) should be treated. When (sub)clinical seizures are treated, there is no consensus about the most appropriate treatment for neonatal seizures and how to assess the efficacy of treatment. Current therapeutic options to treat neonatal seizures (i.e. primarily first generation antiepileptics) are relatively ineffective. There is an urgent need for prospective, randomized, controlled trials for efficacy and safety of these second-generation antiepileptic drugs in neonates. The aim of this review is to survey current knowledge regarding treatment of neonatal seizures in both term and preterm infants.

Keywords: Antiepileptic drugs; Neonatal seizures; Treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Brain / drug effects*
  • Brain / pathology
  • Child Development / drug effects*
  • Drug Resistance
  • Epilepsy / drug therapy
  • Epilepsy / etiology
  • Epilepsy / pathology
  • Epilepsy / physiopathology
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Lidocaine / adverse effects
  • Lidocaine / therapeutic use
  • Midazolam / adverse effects
  • Midazolam / therapeutic use
  • Neurogenesis / drug effects*
  • Neurons / drug effects*
  • Neurons / pathology
  • Neuroprotective Agents / adverse effects
  • Neuroprotective Agents / therapeutic use
  • Phenobarbital / adverse effects
  • Phenobarbital / therapeutic use
  • Premature Birth / physiopathology
  • Seizures / drug therapy*
  • Seizures / etiology
  • Seizures / pathology
  • Seizures / physiopathology
  • Severity of Illness Index

Substances

  • Anticonvulsants
  • Neuroprotective Agents
  • Lidocaine
  • Midazolam
  • Phenobarbital