Anticonvulsants, Other
These agents prevent seizure recurrence and terminate clinical and electrical seizure activity.
Phenobarbital
It is important to use the minimal amount of phenobarbital required and to wait for the anticonvulsant effect to develop before a second dose is given, in order to minimize respiratory distress. Start with the loading dose and continue with the maintenance dosage.
Phenytoin (Dilantin, Phenytek)
Phenytoin should be added to phenobarbital if seizures persist. Phenytoin may act in the motor cortex, where it may inhibit the spread of seizure activity. The activity of brain-stem centers responsible for the tonic phase of grand mal seizures also may be inhibited.
Lorazepam (Ativan)
Lorazepam is a benzodiazepine anticonvulsant. It is used in cases refractory to phenobarbital and phenytoin. By increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain, lorazepam may depress all levels of the CNS, including the limbic and reticular formations.
Levetiracetam (Keppra)
Antiepileptic mechanism unknown. It may inhibit voltage-depedent N-type calcium channels. Levetiracetam may bind to synaptic proteins that modulate neurotransmitter release, and through displacement of negative modulators may facilitate GABA-ergic inhibitory transmission. It is designated as an orphan drug by the FDA for treatment of neonatal seizures.
-
Onset of neonatal seizure demonstrating a focal onset in the right frontal (FP4) region. At this point, the child had head and eye deviation to the left.
-
Twenty seconds into a seizure that had focal onset in the right frontal (FP4) region, the seizure shows a rhythmic buildup of activity in the right frontocentral region.
-
This seizure had focal onset in the right frontal (FP4) region and subsequent buildup of activity in the right frontocentral region. As the seizure evolves, the electroencephalogram shows diffuse involvement of both cerebral hemispheres.
