Efficacy and safety of intravenous Levetiracetam as first-line treatment for neonatal clinical seizures: A single-center study (2021−2023)

Q3 Neuroscience

eNeurologicalSci Pub Date : 2025-08-29 DOI:10.1016/j.ensci.2025.100583

Mojtaba Movahedinia , Seyed Reza Mirjalili , Narges Abedi Ardekani , Farimah Shamsi

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引用次数: 0

Abstract

Background

Neonatal seizures demand urgent treatment to mitigate neurodevelopmental risks. This study evaluates intravenous levetiracetam's efficacy and safety as first-line therapy for seizures in term neonates.

Methods

A retrospective analysis included term neonates with clinical seizures admitted to a NICU (2021–2023), excluding metabolic/other predefined etiologies. All received intravenous levetiracetam initially. Statistical analysis (SPSS v.19) used chi-square and paired t-tests.

Results

The study included 40 neonates, of whom 12 (30 %) were male and 28 (70 %) were female. Tonic seizures were the most frequent type (40 %), followed by myoclonic and mixed seizures (22.5 % each). Hypoxic-ischemic encephalopathy (HIE) was the predominant etiology, accounting for 50 % of cases. No significant association was found between seizure type and the number of doses required (p = 0.051) or seizure recurrence within 48 h (p = 0.485). Additionally, the number of doses administered did not significantly impact seizure recurrence after 48 h (p = 0.63).

Conclusion

Intravenous levetiracetam demonstrated efficacy in controlling neonatal seizures, with no reported drug-related adverse effects. More than 70 % of neonates required only a single dose, and nearly 85 % remained seizure-free within 48 h. While these findings suggest favorable outcomes with levetiracetam, larger, prospective studies are necessary to further substantiate its efficacy and safety profile in this population.

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左乙拉西坦静脉注射一线治疗新生儿临床癫痫发作的疗效和安全性：一项单中心研究（2021 - 2023）

背景：新生儿癫痫发作需要紧急治疗以减轻神经发育风险。本研究评估静脉注射左乙拉西坦作为一线治疗足月新生儿癫痫发作的有效性和安全性。方法回顾性分析2021-2023年入住NICU的临床癫痫发作足月新生儿，不包括代谢/其他预先确定的病因。所有患者最初均接受左乙拉西坦静脉注射。统计分析（SPSS v.19）采用卡方检验和配对t检验。结果共纳入40例新生儿，其中男12例（30%），女28例（70%）。强直性发作是最常见的类型（40%），其次是肌阵挛性发作和混合性发作（各22.5%）。缺氧缺血性脑病（HIE）是主要病因，占病例的50%。发作类型与所需剂量（p = 0.051）或48小时内发作复发（p = 0.485）之间无显著关联。此外，给药次数对48小时后癫痫发作复发没有显著影响（p = 0.63）。结论左乙拉西坦静脉注射可有效控制新生儿癫痫发作，无药物相关不良反应报道。超过70%的新生儿只需要一次剂量，近85%的新生儿在48小时内保持无癫痫发作。虽然这些发现表明左乙拉西坦的有利结果，但需要更大规模的前瞻性研究来进一步证实其在该人群中的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

期刊介绍： eNeurologicalSci provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. eNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). eNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism. The fields covered may include neuroanatomy, neurochemistry, neuroendocrinology, neuroepidemiology, neurogenetics, neuroimmunology, neuroophthalmology, neuropathology, neuropharmacology, neurophysiology, neuropsychology, neuroradiology, neurosurgery, neurooncology, neurotoxicology, restorative neurology, and tropical neurology.