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Practical Approaches to the Treatment of Neonatal Seizures

  • Pediatric Neurology (A Yeshokumar, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

This paper critically reviews the current literature and evidence on diagnosis, classification, clinical approach, and management of neonatal seizures. A stepwise approach for the treatment of neonatal seizures is presented.

Recent findings

In a recent randomized controlled trial comparing phenobarbital to levetiracetam as a first-choice anti-seizure medication with primary outcome seizure free for 24 h, the former was found superior (80% vs 28%, p < 0.001).

Summary

Neonatal seizures require immediate diagnostic and therapeutic interventions. Phenobarbital is the first-line anti-seizure drug for neonatal seizures, but there is little evidence regarding second-line pharmacotherapy. There is a need for more randomized controlled trials for the use of other existing anti-seizure drugs, yet unlicensed in neonates, and the development of new drugs specifically for neonates.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1 3JH, UK

    Maria Chalia MD, MD research

  2. Clinic for Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, 1 Carl-Neuberg Street, 30625, Hannover, Germany

    Hans Hartmann MD

  3. Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1 3JH, UK

    Ronit Pressler MD, PhD

  4. Clinical Neuroscience, University College London, UCL, Ormond Street Institute of Child Health, London, Great, UK

    Ronit Pressler MD, PhD

Authors
  1. Maria Chalia MD, MD research
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  2. Hans Hartmann MD
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  3. Ronit Pressler MD, PhD
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Corresponding author

Correspondence to Maria Chalia MD, MD research.

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Conflict of interest

MC has nothing to declare or any conflicts of interest. HH reports serving as co-chair of the ILAE Pediatrics Commission task force ‘Guideline on Neonatal Seizures.’ RMP is also serving as co-chair of the ILAE Pediatrics Commission task force ‘Guideline on Neonatal Seizures.’ RMP reports personal fees and non-financial support from NATUS, personal fees from UCB, during the conduct of the study; personal fees from GW; from null, outside the submitted work.

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Chalia, M., Hartmann, H. & Pressler, R. Practical Approaches to the Treatment of Neonatal Seizures. Curr Treat Options Neurol 24, 111–127 (2022). https://doi.org/10.1007/s11940-022-00711-w

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