EEG monitoring of therapy for neonatal seizures.

Eleven neonates with seizures had continuous EEGs recorded before and up to several hours after administration of anticonvulsant therapy. Six of seven babies given phenobarbitone responded clinically, but in four of these the EEG showed that seizure discharges either persisted or recurred within two hours. Chloral hydrate had no immediate effect in one case and only a doubtful influence on EEG seizure activity in another. Three babies were given benzodiazepines: after an apparently rapidly effective bolus dose of diazepam, recurrence of seizure discharges was almost immediate. Infusions of diazepam or clonazepam eventually were associated with persistent control of clinical and EEG seizures. In the treatment of neonatal seizures, conventional anticonvulsants are rarely completely effective: EEG monitoring is essential for optimal therapeutic intervention.