The perspective of levetiracetam in neonatal seizures treatment
Authors:
L. Čaklošová; P. Babušík
Authors‘ workplace:
Novorodenecké oddelenie, Hornooravská nemocnica s poliklinikou, Trstená
Published in:
Čes-slov Neonat 2023; 29 (1): 18-22.
Category:
Reviews
Overview
Neonatal seizures are one of the most common neurological emergency. Prompt diagnosis and appropriate treatment are crucial for proper patient's management. The neuronal hyperexcitability of developing brain is an essential predisposing factor for convulsions. Brain damage is determined by seizures etiology, gestational age and EEG findings. However, an adequate therapeutic strategy is no less important for the patient's prognosis. Undiagnosed, improperly treated or refractory convulsions lead to irreversible neurological changes. Seizures can have a negative impact on further neuropsychological development and are associated with a high mortality rate. Phenobarbital is still the first line treatment for neonatal seizures, anyway, new anticonvulsive drugs are entering clinical practice. They have comparable effectiveness but lower incidence of adverse effects. One of acceptable drug from this category is Levetiracetam, which recently has significantly increased in therapeutic use.
Keywords:
neonatal seizures – levetiracetam – phenobarbital
Sources
1. Kim EH, Shin J, Lee BK. Neonatal seizures: diagnostic updates based on new definition and clasHIsification. Clin Exp Pediatr 2022; 65(8): 387–397.
2. Španělová K, Česká K, Ošlejšková H, et al. Novorozenecké záchvaty: současný pohled na problematiku. Cesk. Slov. Neurol. N 2020; 83(1): 48–56.
3. Soul JS, Pressler R, Allen M, et al. International neonatal consortium. Recommendations for the design of therapeutic trials for neonatal seizures. Pediatr Res 2019; 85(7): 943–954.
4. Sandoval Karamian AG, Wusthoff CJ. Antiepileptic drug therapy in neonates. Infectious Disease and Pharmacology 2019; 207–226.
5. Ziobro JM, Eschbach K, Shellhaas RA. Novel therapeutics for neonatal seizures. Neurotherapeutics 2021; 18(3): 1564–1581.
6. Deshpande LS, Delorenzo RJ. Mechanisms of levetiracetam in the control of status epilepticus and epilepsy. Front Neurol 2014; 5: 11.
7. Contreras-García IJ, Cárdenas-Rodríguez N, Romo-Mancillas A, et al. Levetiracetam mechanisms of action: from molecules to systems. Pharmaceuticals 2022; 15(4): 475.
8. Mruk AL, Garlitz KL, Leung NR. Levetiracetam in neonatal seizures: a review. J Pediatr Pharmacol Ther 2015; 20(2): 76–89.
9. Sharpe C, Reiner GE, Davis SL, et al. Levetiracetam versus phenobarbital for neonatal seizures: a randomized controlled trial. Pediatrics 2020; 145(6): e20193182.
10. Bättig L, Dünner C, Cserpan D, et al. Levetiracetam versus phenobarbital for neonatal seizures: a retrospective cohort study. Pediatr Neurol 2023; 138: 62–70.
11. Akeel NE, Suliman HA, Al-Shokary AH, et al. A comparative study of levetiracetam and phenobarbital for neonatal seizures as a first line treatment. Glob Pediatr Health 2022; 9.
12. Manthey D, Asimiadou S, Stefovska V, et al. Sulthiame but not levetiracetam exerts neurotoxic effect in the developing rat brain. Exp Neurol 2005; 193(2): 497–503.
13. Kilicdag H, Daglıoglu K, Erdogan S, et al. The effect of levetiracetam on neuronal apoptosis in neonatal rat model of hypoxic ischemic brain injury. Early Hum Dev 2013; 89(5): 355–60.
14. Hooper RG, Ramaswamy VV, Wahid RM, et al. Levetiracetam as the first-line treatment for neonatal seizures: a systematic review and meta-analysis. Dev Med Child Neurol 2021; 63(11): 1283–1293.
15. Favrais G, Ursino M, Mouchel C, et al. Levetiracetam optimal dose-finding as first-line treatment for neonatal seizures occurring in the context of hypoxic-ischaemic encephalopathy (LEVNEONAT-1): study protocol of a phase II trial. BMJ Open 2019; 9(1): e022739.
Labels
NeonatologyArticle was published in
Czech and Slovak Neonatology
2023 Issue 1
Most read in this issue
- Craniosynostosis
- Diagnostic dilemmas in neonatal meningitis
- Appropriate management of procedural pain in newborn infants
- Spinal muscular atrophy from the neonatologist's point of view