Bibliographic Details
| Title: |
Effectiveness of sodium channel blockers in treating neonatal seizures due to arterial ischemic stroke. |
| Authors: |
Pegoraro, Veronica, Viellevoye, Renaud, Malfilatre, Geneviève, Dilena, Robertino, Proietti, Jacopo, Mauro, Isabella, Zardini, Cecilia, Dzietko, Mark, Lacan, Laure, Desnous, Beatrice, Cordelli, Duccio Maria, Campi, Francesca, Da Silva, Monica Reis, Fumagalli, Monica, Nguyen The Tich, Sylvie, Felderhoff‐Müser, Ursula, Ventura, Giulia, Sartori, Stefano, Benders, Manon, Pittini, Carla |
| Source: |
Epilepsia (Series 4); Feb2025, Vol. 66 Issue 2, p394-406, 13p |
| Subject Terms: |
ISCHEMIC stroke, PHENYTOIN, ANTICONVULSANTS, TREATMENT effectiveness, SEIZURES (Medicine), PHENOBARBITAL, ELECTROENCEPHALOGRAPHY, SODIUM channel blockers |
| Abstract: |
Objective: Few studies have evaluated the efficacy of antiseizure medications (ASMs) according to the etiology of neonatal acute provoked seizures. We aimed to investigate the response to ASMs in term/near term neonates with acute arterial ischemic stroke (AIS), as well as the type of seizure at presentation and the monitoring approach. Methods: We retrospectively evaluated neonates from 15 European level IV neonatal intensive care units who presented with seizures due to AIS and were monitored by continuous electroencephalography (cEEG) and/or amplitude‐integrated EEG (aEEG) in whom actual recordings, timing, doses, and response to ASMs were available for review. Results: One hundred seven neonates were referred, and 88 were included. Of those, 56 met the criteria for evaluating the treatment response. The mean time to treatment was 7.9 h (SD = 16.4), and the most frequently administered first‐line ASM was phenobarbital (PB; 74/88, 84.1%). Seizures were controlled within 24 h from onset of symptoms in 64.3% (36/56) of neonates. Phenytoin (PHT) was effective in almost all neonates in whom it was trialed (24/25, 96.0%), whereas PB was effective in only 22.0% of patients (11/50). Infants treated with PB or PHT as first‐line treatment (53/56, 94.6%) showed a higher response rate with PHT (6/6, 100.0%) than with PB (11/47, 23.4%). Monitoring approach and seizure types were evaluated in 88 infants. Forty‐six of 88 (52.3%) were monitored with cEEG and 47.7% (42/88) with aEEG, with or without intermittent cEEG. The mean monitoring duration was 65.8 h (SD = 39.21). In 83 of 88 (94.3%) infants, the type of seizure suspected clinically prior to monitoring was confirmed afterward. Unilateral focal clonic seizures were seen in 71 of 88 infants (80.7%), whereas 11 of 88 (12.5%) presented with ictal apneas. Significance: Our findings provide evidence in a large, homogenous cohort that PHT is more effective than PB in treating neonatal acute symptomatic seizures due to AIS. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
