Author/Authors :
Falsaperla, Raffaele Neonatal Intensive Care Unit - Santo Bambino Hospital - University Hospital Policlinico-Vittorio Emanuele, catania, Italy , Mauceri, Laura Neonatal Intensive Care Unit - Santo Bambino Hospital - University Hospital Policlinico-Vittorio Emanuele, catania, Italy , Pavone, Piero Department of Pediatrics - AOU Policlinico-Vittorio Emanuele - University of Catania, Italy , Barbagallo, Massimo Department of Pediatrics - Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Italy , Vitaliti, Giovanna Unit of Pediatrics and Pediatric Emergency - University Hospital Policlinico-Vittorio Emanuele, Italy , Ruggieri, Martino Unit of Rare Diseases of the Nervous System in Childhood - Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry - University of Catania, Italy , Pisani, Francesco Child Neuropsychiatry Unit - Medicine & Surgery Department - Neuroscience Division - University of Parma, Italy , Corsello, Giovanni Department of Maternal and Child Health - University of Palermo, Italy
Abstract :
Background. Phenobarbital (PB) has been traditionally used as the first-line treatment for neonatal seizures. More recently,
levetiracetam (LEV) has been increasingly used as a promising newer antiepileptic medication for treatment of seizures in
neonates. Objectives. The aim of our study was to compare the effect of PB vs. LEV on short-term neurodevelopmental outcome
in infants treated for neonatal seizures. Method. This randomized, one-blind prospective study was conducted on term neonates
admitted to the Neonatal Intensive Care Unit of S. Bambino Hospital, University Hospital “Policlinico-Vittorio Emanuele,”
Catania, Italy, from February 2016 to February 2018. Thirty term neonates with seizures were randomized to receive PB or LEV;
the Hammersmith Neonatal Neurological Examination (HNNE) was used at baseline (T0) and again one month after the initial
treatment (T1). Results. We found a significantly positive HNNE score for the developmental outcomes, specifically tone and
posture, in neonates treated with LEV. There was no significant improvement in the HNNE score at T1 in the neonates treated
with PB. Conclusion. This study suggests a positive effect of levetiracetam on tone and posture in term newborns treated for
neonatal seizures. If future randomized-controlled studies also show better efficacy of LEV in the treatment of neonatal seizures,
LEV might potentially be considered as the first-line anticonvulsant in this age group
Keywords :
Short-Term , Neurodevelopmental Outcome , Term Neonates Treated , Phenobarbital versus Levetiracetam , Single-Center Experience
