Intravenous Levetiracetam for Treatment of Seizures in Term and Preterm Neonates

Overview

Journal J Pediatr Neurosci

Specialty Pediatrics

Date 2020 May 22

PMID 32435300

Citations 1

Authors

Pakize Karaoglu

Semra Hiz

Burcin Iscan

Ayse I Polat

Muge Ayanoglu

Nuray Duman

Uluc Yis

Affiliations

Soon will be listed here.

Abstract

Context: Seizures are the most frequent neurological disturbance in the neonatal period, and there are no evidence-based guidelines for the treatment of neonatal seizures. Here we report a study on the use of levetiracetam as second-line therapy in the treatment of seizures in term and preterm neonates.

Aim: The aim of this study was to assess the efficacy and safety of levetiracetam for seizures of term and preterm neonates.

Settings And Design: We retrospectively analyzed data of the patients who had seizures and who were treated with levetiracetam as an add-on therapy to phenobarbital during the neonatal period.

Statistical Analysis: The Statistical Package for the Social Sciences (SPSS) software, version 15.0 (SPSS, Chicago, Illinois), was used for statistical analysis. Continuous variables were expressed as mean values and standard deviations.

Results: Thirty-six patients (8 term and 28 preterm) received levetiracetam. Mean dose of levetiracetam was 31.67 ± 14.83mg/kg/day. Twenty-five of the patients (69.4%) were seizure free with levetiracetam treatment. Electroencephalography recordings improved in 28 (77.8%) of the patients after levetiracetam. No severe adverse effects were observed.

Conclusion: Our data suggest that levetiracetam may be a safe and effective treatment for neonatal seizures, which are unresponsive to phenobarbital.

Citing Articles

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management.

Kirmani B, Au K, Ayari L, John M, Shetty P, DeLorenzo R Aging Dis. 2021; 12(4):1097-1119.

PMID: 34221552 PMC: 8219503. DOI: 10.14336/AD.2021.0302.

References

Abend N, Gutierrez-Colina A, Monk H, Dlugos D, Clancy R . Levetiracetam for treatment of neonatal seizures. J Child Neurol. 2011; 26(4):465-70. PMC: 3082578. DOI: 10.1177/0883073810384263. View

Haberlandt E, Baumgartner Sigl S, Scholl-Buergi S, Karall D, Rauchenzauner M, Rostasy K . Levetiractam in the treatment of two children with myoclonic status epilepticus. Eur J Paediatr Neurol. 2008; 13(6):546-9. DOI: 10.1016/j.ejpn.2008.09.006. View

Pressler R, Mangum B . Newly emerging therapies for neonatal seizures. Semin Fetal Neonatal Med. 2013; 18(4):216-23. DOI: 10.1016/j.siny.2013.04.005. View

Goldberg-Stern H, Feldman L, Eidlitz-Markus T, Kramer U, Perez S, Pollak L . Levetiracetam in children, adolescents and young adults with intractable epilepsy: efficacy, tolerability and effect on electroencephalogram--a pilot study. Eur J Paediatr Neurol. 2012; 17(3):248-53. DOI: 10.1016/j.ejpn.2012.10.008. View

Manthey D, Asimiadou S, Stefovska V, Kaindl A, Fassbender J, Ikonomidou C . Sulthiame but not levetiracetam exerts neurotoxic effect in the developing rat brain. Exp Neurol. 2005; 193(2):497-503. DOI: 10.1016/j.expneurol.2005.01.006. View

Volpe J . Neonatal seizures: current concepts and revised classification. Pediatrics. 1989; 84(3):422-8. View

Kilicdag H, Daglioglu K, Erdogan S, Guzel A, Sencar L, Polat S . The effect of levetiracetam on neuronal apoptosis in neonatal rat model of hypoxic ischemic brain injury. Early Hum Dev. 2012; 89(5):355-60. DOI: 10.1016/j.earlhumdev.2012.12.002. View

Cormier J, Chu C . Safety and efficacy of levetiracetam for the treatment of partial onset seizures in children from one month of age. Neuropsychiatr Dis Treat. 2013; 9:295-306. PMC: 3582481. DOI: 10.2147/NDT.S30224. View

Clancy R . Summary proceedings from the neurology group on neonatal seizures. Pediatrics. 2006; 117(3 Pt 2):S23-7. DOI: 10.1542/peds.2005-0620D. View

10.

Tanriverdi S, Terek D, Altun Koroglu O, Yalaz M, Tekgul H, Kultursay N . Neonatal status epilepticus controlled with levetiracetam at Sturge Weber syndrome. Brain Dev. 2012; 35(4):367-71. DOI: 10.1016/j.braindev.2012.06.005. View

11.

Glass H, Wirrell E . Controversies in neonatal seizure management. J Child Neurol. 2009; 24(5):591-9. DOI: 10.1177/0883073808327832. View

12.

Shoemaker M, Rotenberg J . Levetiracetam for the treatment of neonatal seizures. J Child Neurol. 2007; 22(1):95-8. DOI: 10.1177/0883073807299973. View

13.

Venkatesan C, Young S, Schapiro M, Thomas C . Levetiracetam for the Treatment of Seizures in Neonatal Hypoxic Ischemic Encephalopathy. J Child Neurol. 2016; 32(2):210-214. DOI: 10.1177/0883073816678102. View

14.

Maitre N, Smolinsky C, Slaughter J, Stark A . Adverse neurodevelopmental outcomes after exposure to phenobarbital and levetiracetam for the treatment of neonatal seizures. J Perinatol. 2013; 33(11):841-6. PMC: 4000307. DOI: 10.1038/jp.2013.116. View

15.

McHugh D, Lancaster S, Manganas L . A Systematic Review of the Efficacy of Levetiracetam in Neonatal Seizures. Neuropediatrics. 2017; 49(1):12-17. DOI: 10.1055/s-0037-1608653. View

16.

Vasudevan C, Levene M . Epidemiology and aetiology of neonatal seizures. Semin Fetal Neonatal Med. 2013; 18(4):185-91. DOI: 10.1016/j.siny.2013.05.008. View

17.

Tekgul H, Gauvreau K, Soul J, Murphy L, Robertson R, Stewart J . The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics. 2006; 117(4):1270-80. DOI: 10.1542/peds.2005-1178. View

18.

van Rooij L, Hellstrom-Westas L, de Vries L . Treatment of neonatal seizures. Semin Fetal Neonatal Med. 2013; 18(4):209-15. DOI: 10.1016/j.siny.2013.01.001. View

19.

Khan O, Chang E, Cipriani C, Wright C, Crisp E, Kirmani B . Use of intravenous levetiracetam for management of acute seizures in neonates. Pediatr Neurol. 2011; 44(4):265-9. DOI: 10.1016/j.pediatrneurol.2010.11.005. View

20.

Han J, Moon C, Youn Y, Sung I, Lee I . Efficacy of levetiracetam for neonatal seizures in preterm infants. BMC Pediatr. 2018; 18(1):131. PMC: 5892045. DOI: 10.1186/s12887-018-1103-1. View