Abstract
Seizures in infancy are one of the main manifestations of disorders in the central
nervous system that can have important etiologies. The development of anticonvulsant
drugs and the importance of drug selection in infants, due to more complex underlying
etiologies, compared with older ages, explicate the essentiality of executing clinical
investigations to appraise the optimal therapeutic approach. The objective of the
current investigation is to juxtapose two therapeutic approaches involving intravenous
levetiracetam and intravenous phenobarbital in the management of neonatal seizures.
This is a randomized controlled clinical trial study on 100 infants who were referred
to the Hazrat Masoumeh (S) Hospital in Qom owing to convulsions. Infants with seizure
who fulfilled the inclusion criteria were arbitrarily allocated to one of the two
intervention cohorts: intravenous levetiracetam or intravenous phenobarbital, and
therapeutic responses were compared. There was a substantial relationship between
seizure time, seizure etiology, anticonvulsant therapy type, and treatment responsiveness.
As a result, the risks of not responding to therapy and increasing the dose were approximately
6 and 5 times higher, respectively, in the group that experienced seizures in the
fourth week than in the other groups. Infants with cerebrovascular anomalies were
more prone to not responding to treatment. Furthermore, children administered phenobarbital
had a 2.5-fold higher chance of not responding to treatment than those given levetiracetam
(p = 0.043).
Keywords
levetiracetam - phenobarbital - neonatal seizures
