Levetiracetam in the treatment of neonatal seizures: a pilot study.
OBJECTIVE
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>2000 g, 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/(kg day) 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 pharmacoresistant epilepsy. Seizures relapsed later in the clinical course of two more patients, one of whom was no longer under LEV therapy.


CONCLUSIONS
Results from our small patient group indicate that LEV may be an alternative therapeutic option in neonatal seizures.
Department of Pediatric Neurology, University Children's Hospital, Heidelberg, Germany. a.fuerwentsches@med.uni-heidelberg.de
Alexandra
A
Fürwentsches
Cornelia
C
Bussmann
Georgia
G
Ramantani
Friedrich
F
Ebinger
Heike
H
Philippi
Johannes
J
Pöschl
Susanne
S
Schubert
Dietz
D
Rating
Thomas
T
Bast
D000927:Anticonvulsants / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000077287:Levetiracetam; D008297:Male; D010865:Pilot Projects; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012640:Seizures / Q000628:therapy*; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam