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 language | English |
|---|---|
| Pages (from-to) | 595-599 |
| Journal | Brain and Development |
| Volume | 41 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
Fingerprint
Keywords
- aEEG
- Antiepileptic drugs
- EEG
- Neonatal seizures
- Survey
- Targeted therapy
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Developmental Neuroscience
- Clinical Neurology
Cite this
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, Vol. 41, No. 7, 01.01.2019, p. 595-599.Research output: Contribution to journal › Article
}
TY - JOUR
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
PY - 2019/1/1
Y1 - 2019/1/1
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.
AB - 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.
KW - aEEG
KW - Antiepileptic drugs
KW - EEG
KW - Neonatal seizures
KW - Survey
KW - Targeted therapy
UR - http://www.scopus.com/inward/record.url?scp=85063745815&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063745815&partnerID=8YFLogxK
U2 - 10.1016/j.braindev.2019.03.012
DO - 10.1016/j.braindev.2019.03.012
M3 - Article
AN - SCOPUS:85063745815
VL - 41
SP - 595
EP - 599
JO - Brain and Development
JF - Brain and Development
SN - 0387-7604
IS - 7
ER -