Treating Seizures and Improving Newborn Outcomes for Infants with Hypoxic-Ischemic Encephalopathy

Clin Perinatol. 2024 Sep;51(3):573-586. doi: 10.1016/j.clp.2024.04.013. Epub 2024 May 22.

Abstract

Hypoxic-ischemic encephalopathy is the most common cause of neonatal seizures. Continuous electroencephalographic monitoring is recommended given high rates of subclinical seizures. Prompt diagnosis and treatment of seizures may improve neurodevelopmental outcomes. International League Against Epilepsy guidelines indicate that (1) phenobarbital remains the first-line treatment of neonatal seizures and (2) early discontinuation of antiseizure medications following resolution of acute provoked seizures, and prior to discharge home, is recommended. Long-term follow-up of these infants is necessary to screen for postneonatal epilepsy and support neurodevelopment.

Keywords: EEG; Epilepsy; Neurocritical care; Phenobarbital; Seizure.

Publication types

  • Review

MeSH terms

  • Anticonvulsants* / therapeutic use
  • Electroencephalography*
  • Humans
  • Hypoxia-Ischemia, Brain* / therapy
  • Infant, Newborn
  • Phenobarbital* / therapeutic use
  • Seizures* / drug therapy

Substances

  • Anticonvulsants
  • Phenobarbital