Therapy of neonatal seizures: a two-year retrospective study at Almazov National Medical Research Centre
| العنوان: | Therapy of neonatal seizures: a two-year retrospective study at Almazov National Medical Research Centre |
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| المؤلفون: | G V Odintsova, D. V. Gorshkov, A. M. Shchetinina, D. V. Novoseltsev |
| المصدر: | Rossijskij Vestnik Perinatologii i Pediatrii, Vol 65, Iss 2, Pp 117-124 (2020) |
| بيانات النشر: | The National Academy of Pediatric Science and Innovation, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Pediatrics, medicine.medical_specialty, Valproic Acid, business.industry, medicine.medical_treatment, Symptomatic seizures, RJ1-570, 03 medical and health sciences, 0302 clinical medicine, Anticonvulsant, Supportive psychotherapy, 030225 pediatrics, Pediatrics, Perinatology and Child Health, children, neonatal seizures, neonatal epilepsy, antiepileptic therapy (aet), phenobarbital, diazepam, valproic acid, levetiracetam, Medicine, Phenobarbital, Levetiracetam, business, Oxcarbazepine, Diazepam, 030217 neurology & neurosurgery, medicine.drug |
| الوصف: | Introduction.Neonatal seizures are the most common pathological neurological symptom of the neonatal period, requiring immediate treatment. There are 2 directions in the treatment of seizures: relief of acute life-threatening seizures and supportive antiepileptic therapy of the chronic process. Worldwide phenobarbital is still the first-line medication for neonatal seizures. However, due to contraindications the doctors have to select and prescribe other antiepileptic therapy for both stopping seizures and supportive therapy.Objective.To introduce an algorithm for standardized phased treatment of neonatal seizures from stopping an acute debut to starting supportive chronic therapy according to clinical and electroencephalographic indications.Characteristics of children and research methods.The authors retrospectively analyzed 449 patients born in 2016 – 2017. The inclusion criteria: full-term term newborns with clinical and/or encephalographic verification of seizures in the neonatal period. The authors studied the time distribution parameters of the primary realization of seizures from the time of birth, the genesis of convulsive activity, the effectiveness of antiepileptic therapy.Results.Out of 449 treated children (full-term infants with somatic, surgical and cardiosurgical pathologies) 36 (8.0%) patients had neonatal seizures, 35 (97.33%) children of them had symptomatic seizures. Neonatal genetic epilepsy was diagnosed in 1 (2.77%) child (Otahar syndrome). The investigators revealed the prevalence of the primary realization of convulsive syndrome in newborns in the first 4 days of life. Occasionally the initial debut of seizures occurred in children older than 7 days with congenital metabolic disorders, represented by aminoaciduria. The seizures were stopped without anticonvulsants (correction of transient metabolic disorders – hypoglycemia, hypocalcemia) in 3 (8.33%) children, with phenobarbital monotherapy in 5 (13.89%) children, diazepam monotherapy in 4 (11.11%) children, monotherapy with sodium thiopental – in 5 children (13.89%), valproic acid preparations – in 8 (22.22%) children, a combination of first and second line drugs (sodium thiopental + diazepam; sodium thiopental + phenobrobital) – in 11 ( 30.56%) children. Supportive antiepileptic therapy was carried out using phenobarbital monotherapy in 16 (44.44%) children, valproic acid preparations in 7 (19.44%) children, levetiracetam in 4 (11.12%) children, oxcarbazepine in 2 (5.56 %) children; 7 (19.44%) children were discharged without supportive antiepileptic therapy.Conclusion.Currently anticonvulsant monotherapy is effective in less than 50% of neonatal seizures cases; phenobarbital or diazepam remain the first-line medications. 1/3 of the patients require a combination of antiepileptic therapy. It is of great importance to diagnose and correct transient metabolic disorders before the prescription of anticonvulsant therapy. |
| تدمد: | 2500-2228 1027-4065 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::54c60739901bfd7cce86afe5ae407786Test https://doi.org/10.21508/1027-4065-2020-65-2-117-124Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....54c60739901bfd7cce86afe5ae407786 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25002228 10274065 |
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