Levetiracetam in the treatment of neonatal seizures: A pilot study

Fürwentsches, Alexandra; Bussmann, Cornelia; Ramantani, Georgia; Ebinger, Friedrich; Philippi, Heike; Pöschl, Johannes; Schubert, Susanne; Rating, Dietz; Bast, Thomas

doi:10.1016/j.seizure.2010.01.003

« Previous Next »Seizure: European Journal of Epilepsy
Volume 19, Issue 3 , Pages 185-189, April 2010

Levetiracetam in the treatment of neonatal seizures: A pilot study

Alexandra Fürwentsches
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
- Corresponding author at: Kinderheilkunde V, Pädiatrische Neurologie, Zentrum für Kinder- und Jugendmedizin, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany. Tel.: +49 06221 56 38045; fax: +49 06221 56 5744.
Cornelia Bussmann
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
Georgia Ramantani
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
- Department of Pediatric Neurology, University Children's Hospital, Dresden, Germany
Friedrich Ebinger
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
Heike Philippi
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
Johannes Pöschl
- Department of Neonatology, University Children's Hospital, Heidelberg, Germany
Susanne Schubert
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
Dietz Rating
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany
Thomas Bast
- Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany

Received 1 March 2009; received in revised form 5 January 2010; accepted 7 January 2010. published online 05 February 2010.

Abstract

Purpose

At present, neonatal seizures are usually treated with Phenobarbital (PB) despite the limited efficacy and the potential risk this treatment holds for the developing brain. We report here a prospective pilot feasibility study on the use of Levetiracetam as monotherapy in the treatment of neonatal seizures.

Methods

Six newborns (body weight>2000g, gestational age>30 weeks) presenting with neonatal seizures were enrolled. Patients whose seizures were caused by electrolyte disturbances or hypoglycemia, or whose seizures did respond to pyridoxine were excluded. Patients previously treated with other antiepileptic drugs (AEDs), with the exception of single PB doses before and during titration, were excluded. LEV was administered orally, increasing the dose by 10mg/(kgday) over 3 days. Endpoint was the need of any additional AEDs (or PB) after day 3, or 3 months of LEV treatment. A decision regarding further treatment was made on an individual basis and follow-up was documented up to 8 months of age.

Results

No severe adverse effects were observed. Mild sedation was reported in one infant. All six patients treated with oral LEV became seizure free within 6 days. Five patients remained seizure free after 3 months with ongoing LEV monotherapy. One infant developed pharmacoresistent epilepsy. Seizures relapsed later in the clinical course of two more patients, one of whom was no longer under LEV therapy.