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Comparative Study
. 2019 Apr 29;19(1):136.
doi: 10.1186/s12887-019-1508-5.

Etiology of neonatal seizures and maintenance therapy use: a 10-year retrospective study at Toulouse Children's hospital

E Baudou  1   2 , C Cances  3 , C Dimeglio  4 , C Hachon Lecamus  3
Affiliations
Comparative Study

Etiology of neonatal seizures and maintenance therapy use: a 10-year retrospective study at Toulouse Children's hospital

E Baudou et al. BMC Pediatr. .

Abstract

Background: No guidelines exist concerning the maintenance antiepileptic drug to use after neonatal seizures. Practices vary from one hospital to another. The aim of this study was to investigate etiologies and to report on the use of maintenance antiepileptic therapy in our population of full-term neonates presenting neonatal seizures.

Methods: From January 2004 to October 2014, we retrospectively collected data from all full-term neonates with neonatal seizures admitted to the Children's Hospital of Toulouse, France.

Results: Two hundred and forty-three neonates were included (59% males, 48% electroencephalographic confirmation). The frequencies of etiologies of neonatal seizures were: hypoxic-ischemic encephalopathy (HIE) (n = 91; 37%), ischemic infarction (n = 36; 15%), intracranial hemorrhage (n = 29; 12%), intracranial infection (n = 19; 8%), metabolic or electrolyte disorders (n = 9; 3%), inborn errors of metabolism (n = 5; 2%), congenital malformations of the central nervous system (n = 11; 5%), epileptic syndromes (n = 27; 12%) and unknown (n = 16; 7%). A maintenance therapy was prescribed in 180 (72%) newborns: valproic acid (n = 123), carbamazepine (n = 28), levetiracetam (n = 17), vigabatrin (n = 2), and phenobarbital (n = 4). In our cohort, the choice of antiepileptic drug depended mainly on etiology. The average duration of treatment was six months.

Conclusions: In our cohort, valproic acid was the most frequently prescribed maintenance antiepileptic therapy. However, the arrival on the market of new antiepileptic drugs and a better understanding of the physiopathology of genetic encephalopathies is changing our practice.

Trial registration: Retrospectively registered. Patient data were reported to the "Commission Nationale Informatique et Libertés" under the number 2106953 .

Keywords: Carbamazepine; Etiology; Levetiracetam; Maintenance therapy; Neonatal seizures; Valproic acid.

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Conflict of interest statement

Ethics approval and consent to participate

Retrospectively registered. Patient data were reported to the “Commission Nationale Informatique et Libertés” under the number 2106953. Non-opposition verbal consent was obtained from the parents of the subjects.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow-chart of included newborns
Fig. 2
Fig. 2
Anticonvulsivant maintenance therapy used in 243 term newborns with neonatal seizures at the University Children’s Hospital of Toulouse from 2004 to 2014
Fig. 3
Fig. 3
Anticonvulsivant maintenance therapy depending in 243 term newborns at the University Children’s Hospital of Toulouse from 2004 to 2014
Fig. 4
Fig. 4
Anticonvulsivant maintenance therapy in neonatal seizures in 243 term newborns at the University Children’s Hospital of Toulouse: Evolution of pratices from 2004 to 2014
See this image and copyright information in PMC

References

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