Abstracts

ROLE OF INTRAVENOUS LEVETIRACETAM IN ACUTE SEIZURE MANAGEMENT IN PRETERM NEONATES

Abstract number : 2.233
Submission category : 7. Antiepileptic Drugs
Year : 2012
Submission ID : 16020
Source : www.aesnet.org
Presentation date : 11/30/2012 12:00:00 AM
Published date : Sep 6, 2012, 12:16 PM

Authors :
O. A. Khan, C. Cipriani, C. Wright, R. Castillo, E. D. Crisp, B. Kirmani

Rationale: Due to the treatment of neonatal seizures having limited efficacy and leading to adverse effects, off-label use of antiepileptic drugs in children and neonates is increasing. A pressing need exists to study newer antiepileptic drugs in the neonatal population. Intravenous levetiracetam became available in August 2006 for use in patients above 16 years of age. There are insufficient data about the efficacy and safety of intravenous levetiracetam in preterm neonates. Methods: We retrospectively analyzed data from preterm neonates that were treated with intravenous levetiracetam at our institution between January 2007 and December 2011. Data was acquired from review of our institution's electronic medical record regarding patients who were treated with intravenous levetiracetam during the neonatal period (0-28 days) and were born at preterm gestational age (< 37 weeks). Results: Twelve patients met our inclusion criteria and had received levetiracetam for neonatal seizures. There were 8 females (67%) and 4 males (33%) with gestational ages ranging from 23.3 to 36 weeks. Our primary objective was to assess response to treatment based on clinical and/or electroencephalographic chart documentation. Secondary objectives included indication for initiation of levetiracetam, adverse events, and prevalence of seizure freedom at well child follow-up visits. Response to intravenous levetiracetam was favorable. Nine patients (75%) reached seizure cessation while receiving levetiracetam. No serious side effects were evident. Seven patients (59%) were discharged on oral levetiracetam alone, four patients (33%) were discharged on no oral AED and one patient (8%) was discharged on levetiracetam and phenobarbital. Ten of out of twelve patients were followed up to 6 months after receiving intravenous levetiracetam. Of these, six patients (60%) had achieved seizure freedom and been completely weaned off of all AEDs. Two (20%) had achieved seizure freedom while still on oral levetiracetam. Two (20%) continued to experience seizures on oral levetiracetam. Conclusions: Levetiracetam appears to be efficacious in seizure management in preterm neonates.
Antiepileptic Drugs