How are antiepileptic medications administered in the treatment of neonatal seizures?

Updated: Jul 31, 2019
  • Author: Raj D Sheth, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Answer

Administration of antiepileptic medications should be instituted in an orderly and efficient manner. [20] Initial treatment with phenobarbital should be considered. If seizures persist, phenytoin should be added. Persistent seizures may require the use of an intravenous benzodiazepine, such as lorazepam or midazolam.

As previously stated, seizure medication concentrations should be monitored during the acute period. These drugs often are discontinued between ages 3 and 6 months if further seizures have not occurred. A trend toward earlier discontinuation has met with good results. Hypoglycemia, if present, should be corrected.

Levetiracetam can be effective for patients who do not respond to trandtional AEDs. In 2010, levetiracetam was designated as an orphan drug for neonatal seizures by the FDA. Levetiracetam can be given intravenously. [21]


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