Levetiracetam as the First-line antiepileptic in neonatal seizures

Purkayastha, Jayashree and Lewis, Leslie Edward Simon and Bhat, Ramesh Y and Barche, Apurv and Andrade, Sneha J (2020) Levetiracetam as the First-line antiepileptic in neonatal seizures. Iranian Journal of Neonatology, 11 (4). pp. 39-45. ISSN 2251-7510

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Background: The quest persists for an ideal newer antiepileptic drug (AED) with better efficacy and tolerability. Levetiracetam (LEV) is one of these AEDs with a novel mechanism of action, good pharmacokinetic profile, acceptable tolerability, and side-effect profile. The present study assessed the safety and efficacy of intravenous levetiracetam as a first-line AED in neonatal seizures. Methods: This prospective observational study was conducted on all term neonates with seizures admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary care center. Neonates with hypoglycemia, hypocalcemia, hypomagnesemia, inborn errors of metabolism, or those who received other AEDs prior to admission were excluded from the study. 20mg/kg Intravenous LEV was administered as first-line AED and graded up to 40mg/kg if seizures were not controlled in 2 h; thereafter, second-line AED was added. Results: Only 36.2% (21/58) of the cases responded to LEV as first-line AED. Hypoxic Ischaemic Encephalopathy(HIE) was the most common etiology of seizures (55.2%). Subtle seizures were most responsive to LEV (60%), while multifocal clonic seizures (22.3%) responded the least. No adverse effect of LEV was observed during the study period. Conclusion: Only 36.2% of the cases responded to LEV as first-line AED, and subtle seizures were the most responsive seizures. Therefore, the efficacy of LEV as first-line AED in neonatal seizures is yet to be proven by a larger study. There were no adverse effects of LEV during the study period indicating the relative safety of this drug.

Item Type: Article
Uncontrolled Keywords: Levetiracetam; response; side effects; Seizures; term neonates.
Subjects: Medicine > KMC Manipal > Paediatrics
Depositing User: KMC Library
Date Deposited: 27 Jun 2021 05:58
Last Modified: 27 Jun 2021 05:58
URI: http://eprints.manipal.edu/id/eprint/156874

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