title: Efficacy and safety of lidocaine for treatment of neonatal seizures.
abstract: OBJECTIVE
  Treatment of neonatal seizures still relies primarily on phenobarbital, despite an estimated efficacy of less than 50% and concern over neurodegenerative side effects. The objective of this study was to evaluate the efficacy and safety of lidocaine as second-line treatment of neonatal seizures in infants following benzodiazepine treatment but without previous treatment with phenobarbital.
  
  
  METHODS
  In a 10-year cohort, a retrospective chart review was conducted for all infants (gestational age ≥ 37 w, age ≤ 28 days) who had received lidocaine as second-line treatment of neonatal seizures prior to treatment with phenobarbital between January 2000 and June 2010. Infants were included if they had electroencephalographic seizures.
  
  
  RESULTS
  Cessation of seizure activity was seen in 16 of 30 infants based on clinical and electroencephalographic features, and a probable response was seen in an additional 3 of 30 patients. Suspected adverse effects were seen in only one patient, who developed a transient bradycardia.
  
  
  CONCLUSIONS
  Lidocaine has a moderate efficacy as second-line therapy following benzodiazepines for treating neonatal seizures and is not frequently associated with cardiovascular adverse effects. Lidocaine should therefore be considered in the treatment of seizures in the neonatal period to a higher extent than is the case today.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lundqvist
authors.forename: J
authors.initials: J
authors.lastname: Ågren
authors.forename: L
authors.initials: L
authors.lastname: Hellström-Westas
authors.forename: R
authors.initials: R
authors.lastname: Flink
authors.forename: R
authors.initials: R
authors.lastname: Wickström
mesh_terms: D015331:Cohort Studies; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D061214:Patient Safety; D010634:Phenobarbital / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine; D010634:Phenobarbital
keywords: Anti-epileptic; Early; Epilepsy; Newborn; Phenobarbital