Criteria for discontinuing neonatal seizure therapy: a long-term appraisal.

In order to evaluate the criteria for discontinuing neonatal anticonvulsant treatment, 55 newborns with seizures have been studied. Clinical and EEG serial examinations were performed: soon after the first seizure, throughout the hospital course, and during the follow-up every 3 months until a year, and every 6 months later on. Anticonvulsant treatment with phenobarbital was discontinued (at 4 days-19 months; mean 104 days) on the basis of the following variables: type and number of seizures, time taken for their control, type and persistence of EEG abnormalities, initial neurological features, and seizure etiology. At the follow-up (12 months-8 years; mean 36 months) only 4 children had relapsed, 3 of them with a single short seizure without EEG abnormalities. The results obtained by means of the correlation between the length of anticonvulsant treatment and the clinical and EEG variables provide evidence of the value of the criteria employed. Of these, the duration of persistence of EEG abnormalities was the most important for planning the maintenance of anticonvulsant treatment and its discontinuation.