Neonatal seizures therapy: we are still looking for the efficacious drug

Italian Journal of Pediatrics

Francesco Pisani¹  Elena Pavlidis¹  Carlotta Spagnoli¹ 

[1] Child Neuropsychiatric Unit, Neuroscience Department, University of Parma, Parma, Italy

关键词: Newborns;    Anticonvulsants;    Antiepileptics;    Therapy;    Neonatal seizures;   

Others  :  825105
DOI  :  10.1186/1824-7288-39-37

 received in 2013-03-01, accepted in 2013-05-30,  发布年份 2013

【 摘 要 】

Therapeutic options currently available for neonatal seizures are still unsatisfactory both in terms of efficacy and of risk for long-term neurotoxicity, even if there is growing recognition of their potential to worsen neurodevelopmental outcome. A recent paper by Slaughter and colleagues entitled “Pharmacological treatment of neonatal seizures: a systematic review” has been published with the aim to provide a treatment algorithm, but, due to the relative paucity of clinical studies, it relies mainly on traditional antiepileptic drugs and does not distinguish between different neonatal populations, especially preterm and hypothermic neonates, who might require a dedicated approach in order to improve seizure control and reduce side effects.

【 授权许可】

   
2013 Spagnoli et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Pisani F, Cerminara C, Fusco C, Sisti L: Neonatal status epilepticus vs recurrent neonatal seizures: clinical findings and outcome. Neurology 2007, 69:2177-2185.
• [2]Uria-Avellanal C, Marlow N, Rennie JM: Outcome following neonatal seizures. Semin Fetal Neonatal Medin press
• [3]Slaughter LA, Patel AD, Slaughter JL: Pharmacological treatment of neonatal seizures: a systematic review. J Child Neurol 2013, 28:351-364.
• [4]Booth D, Evans DJ: Anticonvulsants for neonates with seizures. Cochrane Database Syst Re 2004., 18CD004218
• [5]Bhardwaj SK, Forcelli PA, Palchik G, Gale K, Srivastava LK, Kondratyev A: Neonatal exposure to phenobarbital potentiates schizophrenia-like behavioral outcomes in the rat. Neuropharmacology 2012, 62:2337-2345.
• [6]Forcelli PA, Janssen MJ, Vicini S, Gale K: Neonatal exposure to antiepileptic drugs disrupts striatal synaptic development. Ann Neurol 2012, 72:363-372.
• [7]Painter MJ, Scher MS, Stein AD, Armatti S, Wang Z, Gardiner JC, Paneth N, Minnigh B, Alvin J: Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med 1999, 341:485-489.
• [8]Dzhala VI, Talos DM, Sdrulla DA, Brumback AC, Mathews GC, Benke TA, Delpire E, Jensen FE, Staley KJ: NKCC1 transporter facilitates seizures in the developing brain. Nat Med 2005, 11:1205-1213.
• [9]Pérez B, Gutiérrez-Solana LG, Verdú A, Merinero B, Yuste-Checa P, Ruiz-Sala P, Calvo R, Jalan A, Marín LL, Campos O, Ruiz MÁ, San Miguel M, Vázquez M, Castro M, Ferrer I, Navarrete R, Desviat LR, Lapunzina P, Ugarte M, Pérez-Cerdá C: Clinical, biochemical, and molecular studies in pyridoxine dependent epilepsy: Antisense therapy as possible new therapeutic option. Epilepsia 2013, 54:239-248.
• [10]Tulloch JK, Carr RR, Ensom MH: A systematic review of the pharmacokinetics of antiepileptic drugs in neonates with refractory seizures. J Pediatr Pharmacol Ther 2012, 17:31-44.
• [11]Glass HC, Poulin C, Shevell MI: Topiramate for the Treatment of Neonatal Seizures. Pediatr Neurol 2011, 44:439-442.
• [12]Koh S, Tibayan FD, Simpson JN, Jensen FE: NBQX or topiramate treatment after perinatal hypoxia-induced seizures prevents later increases in seizure-induced neuronal injury. Epilepsia 2004, 45:569-75.
• [13]Glier C, Dzietko M, Bittigau P, Jarosz B, Korobowicz E, Ikonomidou C: Therapeutic doses of topiramate are not toxic to the developing rat brain. Exp Neurol 2004, 187:403-409.
• [14]Manthey D, Asimiadou S, Stefovska V, Kaindl AM, Fassbender J, Ikonomidou C, Bittigau P: Sulthiame but not levetiracetam exerts neurotoxic effect in the developing rat brain. Exp Neurol 2005, 193:497-503.
• [15]Trollmann R, Schneider J, Keller S, Strasser K, Wenzel D, Rascher W, Ogunshola OO, Gassmann M: HIF-1-regulated vasoactive systems are differentially involved in acute hypoxic stress responses of the developing brain of newborn mice and are not affected by levetiracetam. Brain Res 2008, 1199:27-36.
• [16]Mastrangelo M, Celato A, Leuzzi V: A diagnostic algorithm for the evaluation of early onset genetic-metabolic epileptic encephalopathies. Eur J Paediatr Neurol 2012, 16:179-191.
• [17]Glass HC, Kan J, Bonifacio SL, Ferriero DM: Neonatal seizures: treatment practices among term and preterm infants. Pediatr Neurol 2012, 46:111-115.
• [18]Van Rooij LG, Hellström-Westas L, De Vries LS: Treatment of neonatal seizures. Semin Fetal Neonatal Medin press
• [19]van den Broek MP, Groenendaal F, Toet MC, Van Straaten HL, Van Hasselt JG, Huitema AD, De Vries LS, Egberts AC, Rademaker CM: Pharmacokinetics and clinical efficacy of phenobarbital in asphyxiated newborns treated with hypothermia: a thermopharmacological approach. Clin Pharmacokinet 2012, 51:671-679.
• [20]van den Broek MP, Rademaker CM, Van Straaten HL, Huitema AD, Toet MC, De Vries LS, Egberts AC, Groenendaal F: Anticonvulsant treatment of asphyxiated newborns under hypothermia with lidocaine: efficacy, safety and dosing. Arch Dis Child Fetal Neonatal Edin press
• [21]Filippi L, La Marca G, Fiorini P, Poggi C, Cavallaro G, Malvagia S, Pellegrini-Giampietro DE, Guerrini R: Topiramate concentrations in neonates treated with prolonged whole body hypothermia for hypoxic ischemic encephalopathy. Epilepsia 2009, 50:2355-2361.
• [22]Barks JD, Liu YQ, Shangguan Y, Silverstein FS: Phenobarbital augments hypothermic neuroprotection. Pediatr Res 2010, 67:532-537.
• [23]van den Broek MP, Groenendaal F, Toet MC, van Straaten HL, van Hasselt JG, Huitema AD, de Vries LS, Egberts AC, Rademaker CM: Pharmacokinetics and clinical efficacy of phenobarbital in asphyxiated newborns treated with hypothermia: a thermopharmacological approach. Clin Pharmacokinet 2012, 51:671-679.
• [24]Liu Y, Barks JD, Xu G, Silverstein FS: Topiramate extends the therapeutic window for hypothermia-mediated neuroprotection after stroke in neonatal rats. Stroke 2004, 35:1460-1465.
• [25]The World Health Organization Guidelines on Neonatal Seizures. 2011. http://apps.who.int/iris/bitstream/10665/77756/1/9789241548304_eng.pdf webcite
• [26]Co JP, Elia M, Engel J Jr, Guerrini R, Mizrahi EM, Moshé SL, Plouin P: Proposal of an algorithm for diagnosis and treatment of neonatal seizures in developing countries. Epilepsia 2007, 48:1158-1164.