Pharmacotherapy for neonatal seizures: current knowledge and future perspectives

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dc.contributor.authorDonovan, Maria D.
dc.contributor.authorGriffin, Brendan T.
dc.contributor.authorKharoshankaya, Liudmila
dc.contributor.authorCryan, John F.
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.funderIrish Research Council for Science, Engineering and Technologyen
dc.contributor.funderSeventh Framework Programmeen
dc.contributor.funderEuropean Commissionen
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2017-01-30T11:51:54Z
dc.date.available2017-01-30T11:51:54Z
dc.date.issued2016-03-04
dc.date.updated2017-01-30T11:34:38Z
dc.description.abstractSeizures are the most common neurological emergencies in the neonatal period and are associated with poor neurodevelopmental outcomes. Seizures affect up to five per 1000 term births and population-based studies suggest that they occur even more frequently in premature infants. Seizures are a sign of an underlying cerebral pathology, the most common of which is hypoxic-ischaemic encephalopathy in term infants. Due to a growing body of evidence that seizures exacerbate cerebral injury, effective diagnosis and treatment of neonatal seizures is of paramount importance to reduce long-term adverse outcomes. Electroencephalography is essential for the diagnosis of seizures in neonates due to their subtle clinical expression, non-specific neurological presentation and a high frequency of electro-clinical uncoupling in the neonatal period. Hypoxic-ischaemic encephalopathy may require neuroprotective therapeutic hypothermia, accompanying sedation with opioids, anticonvulsant drugs or a combination of all of these. The efficacy, safety, tolerability and pharmacokinetics of seven anticonvulsant drugs (phenobarbital, phenytoin, levetiracetam, lidocaine, midazolam, topiramate and bumetanide) are reviewed. This review is focused only on studies reporting electrographically confirmed seizures and highlights the knowledge gaps that exist in optimal treatment regimens for neonatal seizures. Randomised controlled trials are needed to establish a safe and effective treatment protocol for neonatal seizures.en
dc.description.sponsorshipIrish Research Council for Science Engineering and Technology scholarship; Science Foundation Ireland (SFI centre grant (INFANT SFI/12/RC/2272), Centre Grant Number SFI/12/RC/2273); Health Research Board of Ireland (Grant Numbers HRA_POR/2011/23 and HRA_POR/2012/32)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDonovan, M. D., Griffin, B. T., Kharoshankaya, L., Cryan, J. F. and Boylan, G. B. (2016) 'Pharmacotherapy for Neonatal Seizures: Current Knowledge and Future Perspectives', Drugs, 76(6), pp. 647-661. doi:10.1007/s40265-016-0554-7en
dc.identifier.doi10.1007/s40265-016-0554-7
dc.identifier.endpage661en
dc.identifier.issn0012-6667
dc.identifier.journaltitleDrugsen
dc.identifier.startpage647en
dc.identifier.urihttps://hdl.handle.net/10468/3537
dc.identifier.volume76en
dc.language.isoenen
dc.publisherSpringer Verlag; Adisen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/241479/EU/Treatment of NEonatal seizures with Medication Off-patent: evaluation of efficacy and safety of bumetanide/NEMOen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/278948/EU/Translational Adolescent and Childhood Therapeutic Interventions in Compulsive Syndromes/TACTICSen
dc.rights© Springer International Publishing Switzerland 2016. The final publication is available at Springer via http://dx.doi.org/10.1007/s40265-016-0554-7en
dc.subjectHypoxic-ischemic encephalopathyen
dc.subjectAugments hypothermic neuroprotectionen
dc.subjectWhole-body hypothermiaen
dc.subjectTherapeutic hypothermiaen
dc.subjectBrain injuryen
dc.subjectElectrographic seizuresen
dc.subjectAntiepileptic drugsen
dc.subjectPerinatal asphyxiaen
dc.subjectIntravenous levetiracetamen
dc.subjectPopulation pharmacokineticsen
dc.titlePharmacotherapy for neonatal seizures: current knowledge and future perspectivesen
dc.typeArticle (peer-reviewed)en
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