KMID : 0361720140250020083
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Korean Journal of perinatology 2014 Volume.25 No. 2 p.83 ~ p.90
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The Impact of Anticonvulsants on Neurologic Outcomes in Neonatal Seizures
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Han Ji-Yoon
Lee Jin-Hee Park Sun-Young Moon Chung-Joon Youn Young-Ah Sung In-Kyung Lee In-Goo
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Abstract
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Purpose : Although neonatal seizures can cause epilepsy, neurodevelopmental disability, and mortality with high frequency, the use of anti-epileptic drug is limited and the side effect of the drug is unidentified. Thus, authors investigated the prognosis of the neonatal seizures related with anti-epileptic drugs and electroencephalography.
Methods : Retrospective medical records of 37 infants with neonatal seizures under 44 weeks of gestational age who were hospitalized at neonatal intensive care unit in Seoul St. Mary¡¯ Hospital from January to June 2012 were analyzed.
Result : The mean gestational age was 32.5¡¾1.9 weeks and the mean birth weight was 2,010¡¾82 g. Seizures occurred in 65% in infants within 7 days of birth and subtle seizures were most common type. Hypoxic ischemic encephalopathy was the most common cause of seizures and 62% showed abnormal electrographic findings. Among 37 of patients, seizures of 57% were able to be controlled by levetiracetam, but 19% were controlled by co-administration of more than three anti-epileptic drugs. After 6 months of treatment, epilepsy was diagnosed in 6% and developmental delay occurred in 19% among patients controlled by one anti-epileptic drug. Epilepsy and developmental delay occurred in 29% and 86%, respectively, among patients with more than three anti-epileptic drugs. In addition 86% of patients with normal electroencephalographic findings show normal development, but 3 patients with severe abnormalities showed abnormal development.
Conclusion : Neurologic outcome was not good when the number of anti-epileptic drugs were added due to uncontrolled seizures, and the result of electroencephalography showed severe abnormalities.
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KEYWORD
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Levetiracetam, Newborn, Seizures, Levetiracetam
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