content:neonatal_seizures

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content:neonatal_seizures [2020/02/23 14:42] – [Management] icnacontent:neonatal_seizures [2020/02/23 15:39] – [Neonatal seizures] icna
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   * Neonatal epileptic seizures occur from birth to the end of the neonatal period.   * Neonatal epileptic seizures occur from birth to the end of the neonatal period.
   * The neonatal period is defined as the first 28 days of life of a full-term infant.   * The neonatal period is defined as the first 28 days of life of a full-term infant.
-  * Most neonatal seizures are acute (pro-voked, occasional, reactive) symptomatic seizures caused by an acute illness such as hypoxic–ischaemic encephalopathy, stroke or infection.+  * Most neonatal seizures are acute symptomatic seizures caused by an acute illness such as hypoxic–ischaemic encephalopathy, stroke or infection.
   * seizures are the most common and important sign of acute neonatal encephalopathy   * seizures are the most common and important sign of acute neonatal encephalopathy
   * neonatal seizures are a major risk for death or subsequent neurological disability and, by themselves, may contribute to an adverse neuro-developmental outcome.   * neonatal seizures are a major risk for death or subsequent neurological disability and, by themselves, may contribute to an adverse neuro-developmental outcome.
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     * extremely limited evidence on the effect of phenobarbital on long-term neonatal neurodevelopment     * extremely limited evidence on the effect of phenobarbital on long-term neonatal neurodevelopment
     * U.S. Food and Drug Administration (FDA) has never approved phenobarbital for use in any patient population[(:cite:17342837>{{pubmed>17342837}})]     * U.S. Food and Drug Administration (FDA) has never approved phenobarbital for use in any patient population[(:cite:17342837>{{pubmed>17342837}})]
 +    * animal studies have raised concerns that neonatal phenobarbital exposure induces neuronal apoptosis, disruption of synaptic development in the striatum, and other behavioral deficits[(:cite:29315524>{{pubmed>29315524}})]
   * **Levetiracetam**   * **Levetiracetam**
     * effective as second-line treatments for neonatal seizures that are unresponsive to phenobarbital     * effective as second-line treatments for neonatal seizures that are unresponsive to phenobarbital
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