Comparison of Levetiracetam and Phenobarbital for Treating Neonatal Seizures    Associated with Hypoxic-Ischemic Encephalopathy

Abstract

Objective: To compare the effectiveness of Levetiracetam and Phenobarbital for treating neonatal seizures associated with hypoxic-ischemic encephalopathy. Study Design: Quasi-experimental study. Place and Duration of the Study: Department of Neonatology, The Children’s Hospital and Institute of Child Health, Multan Pakistan, from Mar to Nov 2021. Methodology: A total of 132 term neonates of both genders, with birth weight above 1800 grams, presenting within 24 hours of life, with clinical or electric seizures onset secondary to perinatal hypoxia and requiring resuscitation at birth, were included. The neonates were allocated to either Phenobarbital or LEV Group. The efficacy was labelled “yes” if a neonate showed cessation of seizures after the 1st or 2nd dose of the drug and remained seizure-free for the next 24 hours. Results: Out of 132 neonates, 77(58.3%) were male. The mean age was 8.92±4.22 hours. The mean birth weight was 2.29±0.28 kg, ranging between 1.9 and 3 kg. The mean gestational age was 37.67±0.91 weeks. Cessation of seizures occurred among 43(65.2%) neonates in the PB-Group in comparison to 54(81.8%) in the LEV-Group (p=0.030). Mortality was reported in 7(5.3%) neonates (4 in the PB-Group and 3 in the LEV-Group). Conclusion: The LEV was found to be more effective than PB as a first-line treatment agent for neonatal seizure associated with hypoxic-ischemic encephalopathy. Therefore, the LEV can be considered a good and safe alternative to PB for treating NS.

Keywords

• Hypoxic-ischemic encephalopathy, Levetiracetam, Neonatal seizures, Phenobarbital, Seizures.