Influence of etiology on treatment choices for neonatal seizures: A survey among pediatric neurologists

Robertino Dilena, Paola De Liso, Matteo Di Capua, Dario Consonni, Giuseppe Capovilla, Francesco Pisani, Agnese Suppiej, Giovanna Vitaliti, Raffaele Falsaperla, Dario Pruna

Research output: Contribution to journalArticle

Abstract

BACKGROUND: A targeted treatment approach is increasingly promoted in epilepsy management.

AIM: To investigate if etiology (both established or initially presumed) influences antiepileptic drug choice of experts in neonatal seizures.

METHODS: An invitation to participate to a web-based questionnaire was sent to Italian pediatric neurologists affiliated to the Italian Society of Pediatric Neurology (SINP).

RESULTS: 19 pediatric neurologists from different centers, all consultants of third level Neonatal Intensive Care Units (NICUs) answered. As first-line drug phenobarbital was the most common choice, it was used in 79% of cases of acute symptomatic seizures, in 63% of structural epilepsy, in 42% of genetic epilepsies. As second-line drug phenytoin was used by 58% in acute symptomatic seizures, 37% in structural epilepsy, 5% in genetic epilepsy. Pyridoxine/pyridoxalphosphate was much more used in genetic epilepsy (as first-line in 26%, as second-line in 37%) than in the other two conditions. Long-term conventional EEG monitoring was suggested as important to verify efficacy of drugs in controlling seizures by 84% of interviewed neurologists, but EEG was available around the clock in only 53% of their centers. 1 to 3-channel aEEG/EEG (commonly named CFM) was often used instead of conventional EEG monitoring.

CONCLUSION: This is the first survey looking at a targeted approach in treatment of neonatal seizures by pediatric neurologists consulted by NICUs. The treatment approach is similar to previous surveys in case of acute symptomatic seizures, but in case of other etiologies the choices are different, especially for the second-line option. Larger studies should address this topic.

Original languageEnglish
JournalBrain and Development
DOIs
Publication statusE-pub ahead of print - Apr 3 2019

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Epilepsy
Seizures
Pediatrics
Electroencephalography
Neonatal Intensive Care Units
Therapeutics
Pharmaceutical Preparations
Pyridoxine
Phenytoin
Phenobarbital
Neurology
Consultants
Anticonvulsants
Neurologists
Surveys and Questionnaires

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Influence of etiology on treatment choices for neonatal seizures : A survey among pediatric neurologists. / Dilena, Robertino; De Liso, Paola; Di Capua, Matteo; Consonni, Dario; Capovilla, Giuseppe; Pisani, Francesco; Suppiej, Agnese; Vitaliti, Giovanna; Falsaperla, Raffaele; Pruna, Dario.

In: Brain and Development, 03.04.2019.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: A targeted treatment approach is increasingly promoted in epilepsy management.AIM: To investigate if etiology (both established or initially presumed) influences antiepileptic drug choice of experts in neonatal seizures.METHODS: An invitation to participate to a web-based questionnaire was sent to Italian pediatric neurologists affiliated to the Italian Society of Pediatric Neurology (SINP).RESULTS: 19 pediatric neurologists from different centers, all consultants of third level Neonatal Intensive Care Units (NICUs) answered. As first-line drug phenobarbital was the most common choice, it was used in 79{\%} of cases of acute symptomatic seizures, in 63{\%} of structural epilepsy, in 42{\%} of genetic epilepsies. As second-line drug phenytoin was used by 58{\%} in acute symptomatic seizures, 37{\%} in structural epilepsy, 5{\%} in genetic epilepsy. Pyridoxine/pyridoxalphosphate was much more used in genetic epilepsy (as first-line in 26{\%}, as second-line in 37{\%}) than in the other two conditions. Long-term conventional EEG monitoring was suggested as important to verify efficacy of drugs in controlling seizures by 84{\%} of interviewed neurologists, but EEG was available around the clock in only 53{\%} of their centers. 1 to 3-channel aEEG/EEG (commonly named CFM) was often used instead of conventional EEG monitoring.CONCLUSION: This is the first survey looking at a targeted approach in treatment of neonatal seizures by pediatric neurologists consulted by NICUs. The treatment approach is similar to previous surveys in case of acute symptomatic seizures, but in case of other etiologies the choices are different, especially for the second-line option. Larger studies should address this topic.",
author = "Robertino Dilena and {De Liso}, Paola and {Di Capua}, Matteo and Dario Consonni and Giuseppe Capovilla and Francesco Pisani and Agnese Suppiej and Giovanna Vitaliti and Raffaele Falsaperla and Dario Pruna",
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T1 - Influence of etiology on treatment choices for neonatal seizures

T2 - A survey among pediatric neurologists

AU - Dilena, Robertino

AU - De Liso, Paola

AU - Di Capua, Matteo

AU - Consonni, Dario

AU - Capovilla, Giuseppe

AU - Pisani, Francesco

AU - Suppiej, Agnese

AU - Vitaliti, Giovanna

AU - Falsaperla, Raffaele

AU - Pruna, Dario

N1 - Copyright © 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

PY - 2019/4/3

Y1 - 2019/4/3

N2 - BACKGROUND: A targeted treatment approach is increasingly promoted in epilepsy management.AIM: To investigate if etiology (both established or initially presumed) influences antiepileptic drug choice of experts in neonatal seizures.METHODS: An invitation to participate to a web-based questionnaire was sent to Italian pediatric neurologists affiliated to the Italian Society of Pediatric Neurology (SINP).RESULTS: 19 pediatric neurologists from different centers, all consultants of third level Neonatal Intensive Care Units (NICUs) answered. As first-line drug phenobarbital was the most common choice, it was used in 79% of cases of acute symptomatic seizures, in 63% of structural epilepsy, in 42% of genetic epilepsies. As second-line drug phenytoin was used by 58% in acute symptomatic seizures, 37% in structural epilepsy, 5% in genetic epilepsy. Pyridoxine/pyridoxalphosphate was much more used in genetic epilepsy (as first-line in 26%, as second-line in 37%) than in the other two conditions. Long-term conventional EEG monitoring was suggested as important to verify efficacy of drugs in controlling seizures by 84% of interviewed neurologists, but EEG was available around the clock in only 53% of their centers. 1 to 3-channel aEEG/EEG (commonly named CFM) was often used instead of conventional EEG monitoring.CONCLUSION: This is the first survey looking at a targeted approach in treatment of neonatal seizures by pediatric neurologists consulted by NICUs. The treatment approach is similar to previous surveys in case of acute symptomatic seizures, but in case of other etiologies the choices are different, especially for the second-line option. Larger studies should address this topic.

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DO - 10.1016/j.braindev.2019.03.012

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JO - Brain and Development

JF - Brain and Development

SN - 0387-7604

ER -