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Efficacy and safety of intravenous Levetiracetam as first-line treatment for neonatal clinical seizures: A single-center study (2021-2023).
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Movahedinia Mojtaba, Mirjalili Seyed Reza, Ardekani Narges Abedi, Shamsi Farimah
Аннотация
BACKGROUND: Neonatal seizures demand urgent treatment to mitigate neurodevelopmental risks. This study evaluates intravenous levetiracetam's efficacy and safety as first-line therapy for seizures in term neonates.
METHODS: A retrospective analysis included term neonates with clinical seizures admitted to a NICU (2021-2023), excluding metabolic/other predefined etiologies. All received intravenous levetiracetam initially. Statistical analysis (SPSS v.19) used chi-square and paired t-tests.
RESULTS: The study included 40 neonates, of whom 12 (30 %) were male and 28 (70 %) were female. Tonic seizures were the most frequent type (40 %), followed by myoclonic and mixed seizures (22.5 % each). Hypoxic-ischemic encephalopathy (HIE) was the predominant etiology, accounting for 50 % of cases. No significant association was found between seizure type and the number of doses required (p = 0.051) or seizure recurrence within 48 h (p = 0.485). Additionally, the number of doses administered did not significantly impact seizure recurrence after 48 h (p = 0.63).
CONCLUSION: Intravenous levetiracetam demonstrated efficacy in controlling neonatal seizures, with no reported drug-related adverse effects. More than 70 % of neonates required only a single dose, and nearly 85 % remained seizure-free within 48 h. While these findings suggest favorable outcomes with levetiracetam, larger, prospective studies are necessary to further substantiate its efficacy and safety profile in this population.
METHODS: A retrospective analysis included term neonates with clinical seizures admitted to a NICU (2021-2023), excluding metabolic/other predefined etiologies. All received intravenous levetiracetam initially. Statistical analysis (SPSS v.19) used chi-square and paired t-tests.
RESULTS: The study included 40 neonates, of whom 12 (30 %) were male and 28 (70 %) were female. Tonic seizures were the most frequent type (40 %), followed by myoclonic and mixed seizures (22.5 % each). Hypoxic-ischemic encephalopathy (HIE) was the predominant etiology, accounting for 50 % of cases. No significant association was found between seizure type and the number of doses required (p = 0.051) or seizure recurrence within 48 h (p = 0.485). Additionally, the number of doses administered did not significantly impact seizure recurrence after 48 h (p = 0.63).
CONCLUSION: Intravenous levetiracetam demonstrated efficacy in controlling neonatal seizures, with no reported drug-related adverse effects. More than 70 % of neonates required only a single dose, and nearly 85 % remained seizure-free within 48 h. While these findings suggest favorable outcomes with levetiracetam, larger, prospective studies are necessary to further substantiate its efficacy and safety profile in this population.