Relationship of Neonatal Seizure Burden Prior to Treatment and Response to Initial Anti-Seizure Medication.

To assess among a cohort of neonates with hypoxic-ischemic encephalopathy (HIE) the association of pre-treatment maximal hourly seizure burden and total seizure duration with successful response to initial anti-seizure medication (ASM). Retrospective review of data collected from infants enrolled in the HEAL Trial (NCT02811263) between 1/25/2017 and 10/9/2019. We evaluated a cohort of neonates born ≥36 weeks' gestation with moderate to severe HIE who underwent continuous electroencephalogram (EEG) monitoring and had acute symptomatic seizures. Poisson regression analyzed associations between (1)pre-treatment maximal hourly seizure burden, (2)pre-treatment total seizure duration, (3)time from first seizure to initial ASM, and (4)successful response to initial ASM. Among 39 neonates meeting inclusion criteria, higher pre-treatment maximal hourly seizure burden was associated with lower chance of successful response to initial ASM (adjusted relative risk for each 5-minute increase in seizure burden 0.83, 95% CI 0.69-0.99). There was no association between pre-treatment total seizure duration and chance of successful response. Shorter time-to-treatment was paradoxically associated with lower chance of successful response to treatment, although this difference was small in magnitude (RR 1.007, 95% CI 1.003-1.010). Maximal seizure burden may be more important than other, more commonly used measures in predicting response to acute seizure treatments.

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.