PP02.11 – 2668: Efficacy of levetiracetam in a neonatal intensive care cohort.

Objective Neonatal seizures are the most common neurological emergency in newborns. Up to date, phenobarbitone (Pb) is the recommended first-line antiepileptic drug (AED), although animal and human studies have reported neuronal damage (apoptosis and even cell death) and consecutive impairment after its use. Levetiracetam (LEV) seems to have a more favorable profile, but only few data are available concerning its use in newborns. Methods We retrospectively analyzed data from all neonates treated with LEV at our institution 2009–2014 as second line treatment following treatment with Pb. Response was defined as being seizure free (SF) or ≥50% reduction in seizure frequency (SR). Results Data from 35 neonates (21 males) were analyzed. The mean gestational age at birth was 37+1 weeks, birth weight 3060 g. LEV was administered at a mean postnatal age of 16 days. Etiologies were vascular insults in 20 (57.1%), brain malformation in 9 (25.7%), genetic/metabolic disorders in 5 (14.3%) and CNS infections in 1 (2.9%) patients. Duration of LEV treatment was <1 week in 9 (25.7%), up to 1 month in 10 (28.6%), up to 3 months in 7 (20%) and ≥3 months in 9 (25.7%) patients. Complete data sets were only available in 23 patients. 17 (73.9%) responded within the first 24 hours (11 patients SF, 6 patients SR). 2 more patients (8.7%) responded within 30 days after treatment initiation (1 patient SF, 1 patient SR). One patient developed agitation and LEV was therefore withdrawn. No other relevant side effects were observed. Conclusion Our results illustrate that treatment with LEV is effective and safe in newborn infants. Prospective controlled studies and long-term evaluation of developmental outcome are warranted to further assess efficacy and safety of LEV in newborn infants. [ABSTRACT FROM AUTHOR]