6.Effectiveness of Levetiracetam as a First Line Anticonvulsant for Neonatal Seizures
Muhammad Hayat Khan, Syeda Shireen Gul, Qaiser Zaman, Nadeem Ahmad and
Qurrat-ul-Ann
ABSTRACT
Objective: To determine the effectiveness of levetiracetam as a first line anticonvulsant in neonates presenting with seizures at a tertiary care hospital.
Study Design: Prospective study.
Place and Duration of Study: This study was conducted at the Department of Neonatology, Pakistan Institute of Medical Sciences (PIMS) Hospital, Islamabad from 23rd December, 2020 to 22nd June, 2021.
Materials and Methods: One hundred and thirty eight neonates having clinical seizures with and without having documented EEG abnormality were enrolled. Levetiracetam as 50 mg/kg loading dose (diluted in 20 ml normal saline) was administered intravenously in 20 minutes, followed by a maintenance dose of 20 mg/kg intravenously every 12 hours. An additional 20 mg/kg loading dose of levetiracetam was administrated in case of persistent seizures despite initial levetiracetam load. Response to the levetiracetam was considered as the cessation of seizures clinically within a time frame of 30 minutes.
Results: There were 79 (57.2%) males. Overall, mean age was 6.27±6.5 days. Mean birth weight was 2.33±0.64 kg. There were 80 (58.0%) neonates who belonged to urban areas of residence. There were 42 (30.4%) neonates who were born pre-term. Lower segment cesarean section was the commonest mode of delivery noted among 70 (50.7%) cases. Most frequent etiology of seizures was found to be sepsis 57 (41.3%) while hypoxic ischemic encephalopathy was reported in 49 (35.3%). Levetiracetam treatment was found to be successful in 122 (88.4%) neonates. No drug related serious adverse events were reported.
Conclusion: Levetiracetam was found to be highly effective as a first line anticonvulsant in neonates presenting with seizures. No drug related serious adverse events were observed.
Key Words: Levetiracetam, Anticonvulsant, Neonate, Seizures
Citation of article: Khan MH, Gul SS, Zaman Q, Ahmad N, Qurrat-ul-Ann. Effectiveness of Levetiracetam as a First Line Anticonvulsant for Neonatal Seizures. Med Forum 2021;32(8):25-28.