Prospective studies | Population | Etiology | Treatment | Add-on therapy | Outcome |
---|---|---|---|---|---|
Ramantani et al. [27] | N = 38; term and preterm. | N = 9 HIE N = 16 IVH N = 13 sepsis | N = 38 LEV (10–30 mg/kg) | N = 11 PHB as 2nd line | LEV’s efficacy: 79%; 27/30 (90%) remained seizure free at 4 weeks. |
Sharpe et al. [28] | N = 18; term. | N = 8 HIE N = 2 IVH N = 1 birth trauma N = 2 stroke N = 1 brain malformation N = 4 N/A | PHB (20 mg/kg) | LEV (20-40 mg/kg) | LEV’s efficacy: 42%. 5 of the responders were among the 12 subjects who received the higher dose of LEV. |
Furwentsches et al. [29] | N = 6; term and preterm | N = 1 HIE N = 1 IVH N = 3 brain malformation N = 1 N/A | N = 4 oral LEV (10–50 mg/kg) N = 2 PHB (10 mg/kg) | N = 2 LEV | All 6 patients treated with oral LEV became seizure free within 6 days. After 3 months, five out of six patients were seizure free under monotherapy with LEV. |
Falsaperla et al. [30] | N = 16; late preterm and term. | N = 5 MAS N = 8 RDS N = 3 APD | LEV (10–40 mg/kg) | / | LEV’s efficacy: 100%.Seizure freedom reached from 24 h to 15 days. EEGs at three months resulted normal. |
Boylan et al. [31] | N = 17 | N = 7 HIE N = 1 RDS N = 1 IUGR N = 3 sepsis N = 3 prematurity N = 1 NAS N = 1 kernicterus | N = 15 PHB (20–30 mg/kg) | N = 2 PHE (20 mg/kg) | Full response to PHB in 6/17 (35%). Partial response to PHB in 6/17 (35%). No response in 2/17 (12%). |
Low et al. [32] | N = 19 term or near term | N = 10 HIE N = 6 stroke N = 1 CNS infection N = 1 BFNE N = 1 N/A | PHB 10–40 mg/kg i.v. | PHE or MDZ as 2nd line (dose: N/A) | PHB abolished seizurs in 13/19 patients within 1 h. Only 3 patients showed permanent reduction. Loading dose of 20 mg/kg was more effective than 10 mg/kg. |
Van der Broek et al. [33] | N = 53 term newborns | HIE | PHB 20–40 mg/kg | MDZ c.i. 0.05–0.1 mg/kg/h | The observed responsiveness of MDZ add-on therapy after PHB monotherapy was low (23%) compared to PHB monotherapy’s effectiveness (66%). |
Hellstrom- Westas et al. [34] | N = 24 both term and preterm | N = 15 HIE N = 6 IVH N = 2 HIE N = 1 hypoglicemia | N = 24 PHB (10–15 mg/kg) | N = 21 DZP as 2nd line (0.5–2 mg/kg) N = 24 LID as 3rd line (1.6–2.2 mg/kg) | LID’s introduction conducted to seizure cessation in 15/24 patients. 2 of them developed bradycardia and acidosis. |
Maytal et al. [35] | N = 7 | N = 4 HIE N = 2 IVH N = 1 CNS infections | N = 7 PHB (20–40 mg/kg) | N = 7 LRZ (0.05 mg/kg i.v.) | After PHB’s failure, 6/7 patients had complete cessation of seizures within 3 min. 4/6 remained seizure-free on follow-up. No side-effects were reported. |
Glass et al. [36] | N = 92 | N = 30 HIE N = 25 IVH | N = N/A PHB (20 mg/kg) N = N/A LEV (dose: N/A) N = N/A PHE (dose: N/A) | N/A | 64% had seizures that persisted after loading doses of PHB, 58% after LEV and 100% after PHE. . |
Glass et al. [37] | N = 543 term and preterm | N = 284 HIE N = 142 stroke N = 108 IVH | N = 508 PHB N = 21 LEV N = 5 PHE (doses: N/A) | N/A | 354/543 (66%) neonates had incomplete response to the initial loading dose of AED. Incomplete response was similar for PHB (66%), LEV (67%), PHE (80%). |