Efficacy And Safety Of Levetiracetam In The Treatment Of Neonatal Seizures

Objective:To investigate the efficacy and safety of levetiracetam for neonatal seizures and to establish a predictive model.Methods:We retrospectively analyzed 73 neonatal seizure cases(phenobarbital group,35 cases;levetiracetam group,38 cases).The total effective rate,safety and tolerability of levetiracetam were evaluated at 3 days,4 weeks,8 weeks,12 weeks and 16 weeks.A Cox regression survival analysis and a regression tree prediction model were established for the 16-week time point.Results:Levetiracetam's short-term efficacy(3 days)was better than phenobarbital's(p < 0.05),and their long-term efficacies were equivalent.The cumulative survival function suggested that the levetiracetam treatment group could reach the effective point faster than the phenobarbital treatment group(p = 0.009,RR = 2.697).Neurodevelopmental assessments at 16 weeks were not obviously abnormal in either treatment group.The main adverse events with levetiracetam were anorexia and irritability.According to the regression tree prediction model,the top three factors influencing the therapeutic effect were etiological classification,pre-treatment seizure frequency and age of onset.When the etiology was epilepsy or epileptic encephalopathy,levetiracetam's ineffective rate was 66.7%.The Cox regression survival analysis also indicated that the age of onset and etiological classification in covariables affected the therapeutic effect.Conclusion : Levetiracetam shows good efficacy,safety and tolerability for neonatal seizure treatment;however,when the etiology is epilepsy or epileptic encephalopathy,it may not be effective.