Labrecque D, Gal P, Sharpless M K
Clin Pharm. 1984 Nov-Dec;3(6):649-52.
The recurrence of seizures in neonates following discontinuation of phenobarbital was studied. All neonates treated for seizures in the intensive care nursery over a period of four years were followed for seizure recurrence after discharge from the hospital. Of 64 neonates treated for seizures, 50 were followed until they were at least 12 months of age. Their charts were reviewed for birth date, birth weight, gestational age, Apgar scores, age at seizure onset, seizure type, seizure etiology, duration of anticonvulsant therapy, and any neurologic deficits. Information on seizure activity and neurologic and developmental status was obtained through clinic observation or telephone interviews with parents and pediatricians. Anticonvulsant therapy was continued for 4 to 97 days; however, 85% of patients were treated less than three weeks. Those treated longer than three weeks either could not be withdrawn from anticonvulsants or were premature infants who had prolonged, severe illness. The length of follow-up ranged from 12 to 47 months, the average follow-up age being 24 months. Six patients were found to require long-term anticonvulsants because of persistent or recurring seizures. The severity of neurologic damage was a good predictor of seizure recurrence. The duration of anticonvulsant therapy in neonates should be limited to the period when the neonate is acutely ill.
研究了苯巴比妥停药后新生儿癫痫发作的复发情况。对重症监护病房四年期间接受癫痫治疗的所有新生儿出院后进行癫痫复发情况随访。在64例接受癫痫治疗的新生儿中，50例随访至至少12个月龄。查阅他们的病历，记录出生日期、出生体重、胎龄、阿氏评分、癫痫发作起始年龄、癫痫发作类型、癫痫病因、抗惊厥治疗持续时间以及任何神经功能缺损情况。通过临床观察或与家长及儿科医生电话访谈获取癫痫活动以及神经和发育状况的信息。抗惊厥治疗持续4至97天；然而，85%的患者治疗时间不到三周。治疗时间超过三周的患者要么无法停用抗惊厥药物，要么是患有长期重症的早产儿。随访时间为12至47个月，平均随访年龄为24个月。发现6例患者因癫痫持续发作或复发而需要长期使用抗惊厥药物。神经损伤的严重程度是癫痫复发的良好预测指标。新生儿抗惊厥治疗的持续时间应限于新生儿急性患病期间。
