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Efficacy of Phenobarbital in Neonatal Seizures

Published online by Cambridge University Press:  18 September 2015

C.B. Van Orman  and
H.Z. Darwish
C.B. Van Orman
Affiliation:
Departments of Pediatrics and Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary
H.Z. Darwish*
Affiliation:
Departments of Pediatrics and Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary
*
Alberta Children’s Hospital, 1820 Richmond Road S.W., Calgary, Alberta T2T 5C7
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Abstract:

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A retrospective study of neonatal seizures in a tertiary care neonatal intensive care unit determined a 3.2% incidence, and confirmed the relatively poor efficacy of the traditional anticonvulsants phenobarbital and phenytoin. Only 33% responded to an initial adequate loading dose of phenobarbital, while 56% responded to either or both anticonvulsants. Although multifocal clonic seizures were most common (42%), tonic seizures were next in freqency (30%). Tonic seizures which did not respond to phenobarbital responded quite poorly to the addition of phenytoin compared to other seizure types. Tonic seizures may be the result of brainstem release phenomena and require a different strategy for management. Among nonresponders in this study, there was a 56% mortality rate but only 33% of responders died. There is a critical need for studies to find more efficacious agents than phenobarbital and phenytoin to treat seizures in the newborn.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 12 , Issue 2 , May 1985 , pp. 95 - 99
Copyright
Copyright © Canadian Neurological Sciences Federation 1985

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