Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2015; 4(3): 45-49
Published online Aug 8, 2015. doi: 10.5409/wjcp.v4.i3.45
Response of levetiracetam in neonatal seizures
Maggie Lo-Yee Yau, Eva Lai-Wah Fung, Pak Cheung Ng
Maggie Lo-Yee Yau, Eva Lai-Wah Fung, Pak Cheung Ng, Department of Paediatrics, the Chinese University of Hong Kong, Hong Kong, China
Author contributions: Yau MLY retrieved the clinical information and prepared the manuscript; Fung ELW performed the literature search and prepared the manuscript; Ng PC supervised the management of the neonates and revised the final manuscript.
Supported by Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref.), No. 2014.072.
Institutional review board statement: The study was reviewed and approved by the Chinese University of Hong Kong Institutional Review Board.
Informed consent statement: Since this is an observational study, no informed consent was obtained from the participants.
Conflict-of-interest statement: All authors declare no conflict of interests associated with the preparation of the manuscript.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eva Lai-Wah Fung, MB, ChB, Department of Paediatrics, the Chinese University of Hong Kong, Rm 84034, 6/F, LCW Clinical Sciences Bldg., Prince of Wales Hospital, Shatin, Hong Kong, China. eva_fung@cuhk.edu.hk
Telephone: +852-26322981 Fax: +852-26360020
Received: April 20, 2015
Peer-review started: April 24, 2015
First decision: May 13, 2015
Revised: May 25, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: August 8, 2015

AIM: To review the clinical response to levetiracetam (LEV) in neonatal seizure management in intensive care unit.

METHODS: Medical records of neonates who received LEV from January 2009 to August 2014 were reviewed. Their demographic data, clinical characteristics, etiology, seizures, electroencephalograms, response to treatment and outcome were noted. Literature review of use of LEV in neonates were also performed via PubMed and EMBASE with keywords - “neonates”, “seizures”, “epilepsy” and “LEV” up to Sep 2014 and retrieved the publications. The response rate to LEV was compared.

RESULTS: Twelve neonates were identified during the study period. All patients received phenobarbitone loading prior to consideration of LEV. Seven (58%) and nine (75%) achieved seizure freedom 24 h and 72 h after LEV was added, both clinically and electrographically. No serious adverse effects were associated with LEV use. From the literature, there are total 144 neonates reported to have used LEV. The overall results suggested that LEV could control up to 90% of neonatal seizures.

CONCLUSION: LEV was found to be relatively safe and efficacious in treating neonatal seizures, but might not work well in the most severe hypoxic ischemic encephalopathy.

Keywords: Levetiracetam, Phenobarbitone, Neonates, Seizures

Core tip: Neonatal seizures are common, but there is lack of evidence to support use of anticonvulsants in this group of patients. Phenobarbitone remains the first line of treatment despite its limitations. The current study aims to review our experience of using levetiracetam (LEV) in management of neonatal seizures and to compare with the experience reported in the literature. We find that LEV is a relatively safe and feasible treatment option. Difficulties in performing studies were also discussed with the latest report of using bumetanide for treatment of neonatal seizures.