Journal of Pediatric Neurology - Volume 7, issue 1

Authors: Soul, Janet

Article Type: Research Article

Abstract: Novel medications to treat neonatal seizures have been the subject of numerous recent basic science research and clinical papers describing the potential and need for more effective and safe antiepileptic drugs (AEDs) for this unique population. This interest has been fueled in part by the notion that seizures, particularly when refractory, likely contribute to brain injury, later epilepsy and neurodevelopmental impairments. The population of newborns with seizures presents unique challenges, because of the often significant …differences in the pharmacokinetics, safety and efficacy of medications when compared with older children and adults. Bumetanide and topiramate are two novel AEDs that have mechanisms of action uniquely suited to suppressing seizures in the newborn brain, with promising basic science data supporting their use in human newborns. Furthermore, these novel medications offer the potential of neuroprotective effects when used to treat refractory seizures caused by acute insults to the neonatal brain. The available data regarding the mechanism of action, pharmacokinetics, and safety of these two AEDs will be described, as well as the data needed to bring these two agents into routine use in the human newborn with seizures. Show more

Keywords: Neonatal seizures, bumetanide, topiramate, hypoxic-ischemic encephalopathy, brain injury, pharmacokinetics, safety, neuroprotection, neurologic outcome

DOI: 10.3233/JPN-2009-0271

Citation: Journal of Pediatric Neurology, vol. 7, no. 1, pp. 85-93, 2009

Authors: Guillet, Ronnie

Article Type: Research Article

Abstract: The treatment of infants with antiepileptic medications after the resolution of neonatal seizures is highly variable and controversial. Infants are commonly treated with phenobarbital after their seizures have resolved to prevent recurrence. Data to support this practice are lacking but animal models suggest that the neonatal brain is vulnerable to repeated seizures. Yet exposure of the developing brain to phenobarbital for prolonged periods may have deleterious consequences. We discuss current clinical practice and present …information on risks and benefits of continued treatment with phenobarbital after resolution of neonatal seizures. Show more

Keywords: Phenobarbital, neonate, seizures, brain development

DOI: 10.3233/JPN-2009-0266

Citation: Journal of Pediatric Neurology, vol. 7, no. 1, pp. 95-99, 2009