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左乙拉西坦和苯巴比妥单药治疗新生儿临床惊厥对足月儿神经认知结局的比较。

Comparison of the neurocognitive outcomes in term infants treated with levetiracetam and phenobarbital monotherapy for neonatal clinical seizures.

作者信息

Arican Pinar, Olgac Dundar Nihal, Mete Atasever Neslihan, Akkaya Inal Mine, Gencpinar Pinar, Cavusoglu Dilek, Akbay Sinem, Tekgul Hasan

机构信息

Department of Pediatric Neurology, Kahramanmaraş Necip Fazil Hospital, Kahramanmaraş, Turkey.

Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey.

出版信息

Seizure. 2020 Aug;80:71-74. doi: 10.1016/j.seizure.2020.06.006. Epub 2020 Jun 5.

Abstract

PURPOSE

This study aims to compare the neurocognitive outcome in term infants who were treated using phenobarbital (PB) and levetiracetam (LEV) monotherapy for neonatal clinical seizures.

METHODS

Term infants who were treated using PB or LEV monotherapy as the first-line anti-epileptic treatment for neonatal clinical seizures and followed-up in a pediatric neurology outpatient clinic were enrolled in this study. Neurodevelopmental outcome assessments were carried out using the Bayley Scales of Infant Development, third edition (BSID-III), including cognitive, receptive language, expressive language, fine motor and gross motor subscales.

RESULTS

The study group consisted of 62 infants who received monotherapy with PB monotherapy (n = 22) and LEV (n = 40). The mean duration of monotherapy treatment was 8 ± 6 months. There was no statistically significant difference between PB and LEV monotherapy groups concerning each outcome parameter on the BSID-III. There was also no statistically significant difference between PB and LEV monotherapy subgroups excluding the infants with neurodevelopmental impairment with a BSID-III scale score<7 or a composite score<85.

CONCLUSION

Our findings suggest that both LEV and PB therapy can be equally safe as monotherapy for neonatal clinical seizures for the neurodevelopmental outcome assessment with BSID-III.

摘要

目的

本研究旨在比较使用苯巴比妥(PB)和左乙拉西坦(LEV)单药治疗新生儿临床癫痫发作的足月儿的神经认知结局。

方法

本研究纳入了使用PB或LEV单药作为新生儿临床癫痫发作的一线抗癫痫治疗并在儿科神经科门诊进行随访的足月儿。使用贝利婴幼儿发展量表第三版(BSID-III)进行神经发育结局评估,包括认知、接受性语言、表达性语言、精细运动和大运动分量表。

结果

研究组由62例接受PB单药治疗(n = 22)和LEV单药治疗(n = 40)的婴儿组成。单药治疗的平均持续时间为8±6个月。在BSID-III的各结局参数方面,PB和LEV单药治疗组之间无统计学显著差异。在排除BSID-III量表评分<7或综合评分<85的神经发育受损婴儿后,PB和LEV单药治疗亚组之间也无统计学显著差异。

结论

我们的研究结果表明,对于使用BSID-III进行神经发育结局评估而言,LEV和PB治疗作为新生儿临床癫痫发作的单药治疗同样安全。

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