title: Phenobarbitone versus phenytoin for treatment of neonatal seizures: an open-label randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of phenobarbitone and phenytoin for treatment of neonatal seizures in term and near-term neonates.
  
  
  METHODS
  Open labeled randomized controlled trial.
  
  
  METHODS
  Neonatal intensive care unit of a level II unit from India, from November 2008 to September 2009.
  
  
  METHODS
  All term and late pre-term neonates admitted with clinically apparent seizures and not having any transient metabolic disorders (hypoglycemia or hypocalcemia) were randomly assigned.
  
  
  METHODS
  Phenobarbitone (n=54) or phenytoin (n=55) intravenously 20 mg/kg/dose over 20-30 min. Neonates whose seizures were not controlled by the assigned drug were then crossed over to be treated with other drug in same dose.
  
  
  METHODS
  Clinical control of seizures (seizure free period of 24 hours after giving anticonvulsant).
  
  
  RESULTS
  Baseline characteristics including mean birthweight, gestation age and sex were comparable in both groups. Seizures were controlled in 8 of the 55 (14.5%) neonates who received phenytoin, as compared to 39 of 54 (72.2%) neonates who received phenobarbitone (P <0.001). In babies not responding to assigned drugs, after cross-over to the other drug, seizure control was achieved in 44/55 (80%) of the neonates assigned to receive phenytoin first as compared to 49/54 (91%) of those assigned to receive phenobarbitone first (P=0.014). After maximum dose of phenobarbitone seizures were controlled in 49/55(89%) in phenytoin group and 52/54 (96%) in phenobarbitone group (P<0.05).
  
  
  CONCLUSIONS
  Phenobarbitone is more efficacious than phenytoin in control of clinical seizures in term or near-term neonates, irrespective of etiology. To evaluate serum vascular endothelial growth factor (VEGF) levels in children with acute lymphoblastic leukemia (ALL) during the induction phase of chemotherapy.
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut;Department of Pediatrics, Government Medical College, Chandigarh; and Department of Pediatrics, Subharti Medical College, Meerut, UP, India. Correspondence to: Dr Amit Upadhyay, Department of Pediatrics, LLRM Medical College, Meerut, India. anuamit7@rediffmail.com.
authors.forename: Garima
authors.initials: G
authors.lastname: Pathak
authors.forename: Amit
authors.initials: A
authors.lastname: Upadhyay
authors.forename: Umesh
authors.initials: U
authors.lastname: Pathak
authors.forename: Deepak
authors.initials: D
authors.lastname: Chawla
authors.forename: Sneh P
authors.initials: SP
authors.lastname: Goel
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy*; D008297:Male; D010634:Phenobarbital / Q000627:therapeutic use*; D010672:Phenytoin / Q000627:therapeutic use*; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin; D010634:Phenobarbital