Ríos FBA, Ibarra PJ, Olivas PE, Munive BL

Language: Spanish
References: 31
Page: 199-204
PDF size: 41.43 Kb.

ABSTRACT

Epileptic seizure is the most common sign of neurological dysfunction in neonates and may be the only clinical manifestation of central nervous system involvement. Indeed, seizures may have or not a clinical expression making the diagnosis to be difficult and so the treatment. The gold standard for the diagnosis of neonatal seizures remains the video electroencephalogram. It has been an increasing concern about the opportune treatment of the neonatal seizures, because now it’s recognized their possible harm in the immature brains.
Of the available antiepileptic drugs, none of them have demonstrated to be enough efficient and safe; moreover, there is evidence that some of them can be deleterious in the neurodevelopment. Topiramate and levetiracetam have been used recently in neonates with encouraging results, offering the last drug second a different action mechanism and novel pharmacokinetics advantages.
Case 1: Male with mioclonic crisis due to hypoxic encephalopathy. He did not response to phenitoin, phenobarbital or midazolam, but with appropriate response to intravenous levetiracetam. Case 2: Premature with clonic focal crisis due to meningitis unresponsive to conventional antiepileptic drugs including lidocaine, but with a favorable outcome after intravenous levetiracetam. Case 3: Female with holoprosecephaly who have had persistent epileptic seizures in spite of first line antiepileptic and also levetiracetam. Case 4: Premature newborn with epileptic seizures due to intraventricular hemorrhage with a good response to levetiracetam.
We present the results of four neonates with persistent epileptic seizures in spite of using first line antiepileptic drugs that were treated with levetiracetam with encouraging results in three of them. Levetiracetam has become a useful therapeutic strategy for unresponsive epileptic seizures in children.

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