Evidence-Based Guidelines For Managing Seizures In Neonates
26 Sept 2023 • The Neonatal Task Force of the International League Against Epilepsy (ILAE) has issued a set of evidence-based recommendations for the management of seizures in neonates, addressing the significant variability in management approaches. The task force formulated six priority questions, conducted a systematic review and meta-analysis, and evaluated the quality of evidence following rigorous standards. Their recommendations cover several key aspects of neonatal seizure management.
- Firstly, phenobarbital is recommended as the first-line antiseizure medication (ASM) for neonates, regardless of the cause of seizures.
- However, if a channelopathy is suspected, other options like phenytoin or carbamazepine should be considered.
- Secondly, for neonates not responding to the initial ASM, alternatives such as phenytoin, levetiracetam, midazolam, or lidocaine may be used as second-line options.
- Additionally, therapeutic hypothermia is suggested for reducing seizure burden in neonates with hypoxic-ischemic encephalopathy.
- Treating neonatal seizures to minimize seizure activity may improve outcomes, and pyridoxine can be considered for neonates with features of vitamin B6-dependent epilepsy.
- It's also emphasized that ASMs should be discontinued before discharging neonates without evidence of neonatal-onset epilepsy.
These recommendations aim to provide clarity and consistency in the management of neonatal seizures and promote informed decision-making among healthcare providers.
Source: PracticeUpdate | Read full story