Response to antiseizure medications in neonates with acute symptomatic seizures
Summary
In a prospective cohort of 534 neonates with acute symptomatic seizures, 66% had incomplete response to the initial loading dose of antiseizure medication (ASM). Treatment response did not differ by gestational age, sex, medication, or dose. The risk of incomplete response was highest for seizures due to intracranial hemorrhage and lowest for hypoxic-ischemic encephalopathy, although the difference was not significant after adjusting for high seizure burden and therapeutic hypothermia treatment. Future trial design may test ASMs in neonates with all acute symptomatic seizure etiologies and could target neonates with seizures refractory to an initial ASM.
DISCLOSURE OF CONFLICT OF INTEREST
J.S.S. receives royalties from UpToDate. C.J.W. has served as a paid consultant for Ceribell and Persyst. M.R.C. received research funding from Insys Development Company, paid to her Institution, for company sponsored trials; she has been a consultant for BioMarin Research and for GW Pharmaceuticals. R.A.S. is a consultant for the Epilepsy Study Consortium and receives honoraria from UpToDate for neonatal seizures topics. None of the other authors has any conflict of interest to disclose. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
