Background: Seizures in newborns are frequent throughout the first month of life and might affect their neurodevelopment. Despite its limited effectiveness and association with cognitive impairment in human subjects, phenobarbitone (PB) is presently the preferred anti-epileptic medication (AED). The use of intravenous levetiracetam to treat seizures in neonates is growing. We have designed a randomized control study using levetiracetam in the initial treatment of acute newborn seizures since there is currently inadequate information on the safety and effectiveness of intravenous levetiracetam in neonates. The objective of the research was to determine if levetiracetam is more applicable than phenobarbitone at reducing convulsions in acute newborn seizures. The procedure of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. The outcome of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. In conclusion, the study found that when used as a first-line antiepileptic medication to treat acute newborn seizures, levetiracetam dramatically reduces convulsions when compared to phenobarbitone. It was discovered that none of the therapy techniques had any negative effects.
| Published in | American Journal of Pediatrics (Volume 11, Issue 2) |
| DOI | 10.11648/j.ajp.20251102.11 |
| Page(s) | 34-42 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2025. Published by Science Publishing Group |
Neonatal Seizures, Phenobarbitone Treatment, Levetiracetam in Neonates, Neonatal Seizure Management, Seizure Control in Neonates, Neonatal Anticonvulsants
Parameters | Intervention Group (n=50)% | Control Group (n=50)% | P value (X2 test) |
|---|---|---|---|
Sex | |||
Male | 30 (60.0) | 37 (74.0) | 0.137 (%) |
Female | 20 (40.0) | 13 (26.0) | |
Gestational age (weeks) | NO. (%) | NO. (%) | P value (X2 test) |
|---|---|---|---|
Premature (<37) | 6 (12.0) | 5 (10.0) | 0.749 |
Full-term (37-42) | 44 (88.0) | 45 (90.0) | |
Mean ±SD | 38.00±1.43 | 38.06±1.11 | 0.815 |
Parameters | Intervention Group (n=50)% | Control Group (n=50)% | P value (X2 test) |
|---|---|---|---|
Birth Weight | NO. (%) | NO. (%) | |
2000- <2500 | 8 (16.0) | 9 (18.0) | 0.790 |
2500-4000 | 42 (84.0) | 41 (82.0) | |
Mean ±SD | 2776.00±267.50 | 2750.20±345.48 | 0.677 |
Range | 2300.03-3200.0 | 2000.0-3400.0 |
Apgar score for neonates delivered in hospital | |
|---|---|
(n=26) | (n=14). |
No. (%) | No. (%) |
26 (100.0) | 14 (100.0) |
Breathing status of neonates delivered outside hospital | |||
|---|---|---|---|
Parameters | (n=26) | (n=14) | P value (X2 test) |
No. (%) | No. (%) | ||
No breathing Within 1 minute | 19 (79.2) | 31 (86.1) | 0.480 |
Breathing within1 minute | 5 (20.8) | 5 (13.9) | |
Parameters | Intervention Group (n=50)% | Control Group (n=50)% | P value (X2 test) |
|---|---|---|---|
Age on admission (hour) | No (%) | No (%) | 0.72 |
12 | 35 (70.0) | 27 (54.0) | |
>12-24 | 9 (18.0) | 12 (24.0) | |
>24-36 | 3 (6.0) | 6 (12.0) | |
>36-48 | 2 (4.0) | 4 (8.0) | |
>48 | 1 (2.0) | 1 (2.0) | |
Age at onset (hour) | No. (%) | No (%) | 0.101 |
12 | 38 (76.0) | 32 (64.0) | |
>12-24 | 8 (16.0) | 10 (20.0) | |
>24-36 | 1 (2.0) | 7 (14.0) | |
>36-48 | 3 (6.0) | 1 (2.0) | |
Type of seizure | No. (%) | No (%) | 0.137 |
Subtle | 18 (36.0) | 14 (28.0) | |
Clonic | 22 (44.0) | 21 (42.0) | |
Tonic | 6 (12.0) | 14 (28.0) | |
Myoclonic | 1 (2.0) | 1 (2.0) |
Parameters | Intervention Group (n=50)% | Control Group (n=50)% | P value (X2 test) |
|---|---|---|---|
No (%) | No (%) | ||
Seizure Controlled | 0.005** | ||
Yes | 33 (66.0) | 19 (38.0) | |
No | 17 (34.0) | 31 (62.0) | |
More than one drug required To Control seizure | 0.005** | ||
Yes | 17 (34.0) | 31 (62.0) | |
No | 33 (66.0) | 19 (38.0) | |
Time required to control Seizure (hour) | 0.030* | ||
12 | 40 (80.0) | 25 (50.0) | |
>12-24 | 6 (12.0) | 12 (24.0) | |
>24-36 | 2 (4.0) | 4 (8.0) | |
>36-48 | 1 (2.0) | 6 (12.0) | |
>48 | 1 (2.0) | 3 (6.0) | |
Mean ±SD | 6.88±15.47 | 19.41±17.35 | 0.0001*** |
Range | 0.33-93.00 | 0.50-69.00 |
Parameters | Intervention Group (n=50)% | Control Group (n=50)% | P value (X2 test) |
|---|---|---|---|
No. (%) | No. (%) | ||
Adverse Effect | 0.372 | ||
Yes | 5 (100) | 8 (16.0) | |
No | 45 (90.0) | 42 (84.0) | |
Type of adverse effects | NO. (%) | NO. (%) | |
Somnolence | 3 (60.0) | ||
Irritability | 2 (40.0) | ||
Drowsiness | 4 (50.0) | ||
Lethargy | 4 (50.0) | ||
Treatment Outcome | |||
Discharged with Advice | 37 (34.0) | 36 (72.0) | 0.473 |
Left against | 11 (22.0) | 9 (18.0) | |
Medical Advice Expired | 2 (4.0) | 5 (10.0) | |
Hospital stay (days) | |||
<5 | 9 (18.0) | 1 (2.0) | 0.001** |
5-7 | 29 (58.0) | 18 (36.0) | |
8-10 | 10 (20.0) | 26 (52.0) | |
>10 | 2 (4.0) | 5 (10.0) | |
Mean ± SD | 6.22±2.20 | 8.10 ± 2.17 | 0.0001 |
Range | 2.00-12.00 | 4.00-1200 | |
Table 4 displays the treatment results for the neonatal intervention group and control group. 5 (10%) and 8 (16%) neonates in the intervention group and control group, respectively, had negative medication effects. There was no statistically significant variance found. 2 (40%) and 3(60%) of the 5 infants in the intervention group exhibited irritability and somnolence, whereas 4 (50%) of the 8 neonates in the control group displayed lethargy and sleepiness.. | [1] | Islam MA, Khan MS, Khan AA, Narapureddy BR, Lingala KVR, Nasir N, Muzammil K, Ahmad I, Dawria A, Faheem A, Mohieldin A. Newborn Care Practices and Associated Factors Influencing Their Health in a Northern Rural India. Children (Basel). 2023 Feb 20; 10(2): 408. |
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APA Style
Rahman, M. M., Mollah, A. H., Islam, M. S., Baki, S. M. A. A. (2025). Phenobarbitone Versus Levetiracetam: A Qualified Approach to Initial Neonatal Seizure Management. American Journal of Pediatrics, 11(2), 34-42. https://doi.org/10.11648/j.ajp.20251102.11
ACS Style
Rahman, M. M.; Mollah, A. H.; Islam, M. S.; Baki, S. M. A. A. Phenobarbitone Versus Levetiracetam: A Qualified Approach to Initial Neonatal Seizure Management. Am. J. Pediatr. 2025, 11(2), 34-42. doi: 10.11648/j.ajp.20251102.11
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Download@article{10.11648/j.ajp.20251102.11,
author = {Mohammed Mahfuzur Rahman and Abid Hossain Mollah and Md Saiful Islam and Shaha Mohammad Abdullah Al Baki},
title = {Phenobarbitone Versus Levetiracetam: A Qualified Approach to Initial Neonatal Seizure Management},
journal = {American Journal of Pediatrics},
volume = {11},
number = {2},
pages = {34-42},
doi = {10.11648/j.ajp.20251102.11},
url = {https://doi.org/10.11648/j.ajp.20251102.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.11},
abstract = {Background: Seizures in newborns are frequent throughout the first month of life and might affect their neurodevelopment. Despite its limited effectiveness and association with cognitive impairment in human subjects, phenobarbitone (PB) is presently the preferred anti-epileptic medication (AED). The use of intravenous levetiracetam to treat seizures in neonates is growing. We have designed a randomized control study using levetiracetam in the initial treatment of acute newborn seizures since there is currently inadequate information on the safety and effectiveness of intravenous levetiracetam in neonates. The objective of the research was to determine if levetiracetam is more applicable than phenobarbitone at reducing convulsions in acute newborn seizures. The procedure of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. The outcome of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. In conclusion, the study found that when used as a first-line antiepileptic medication to treat acute newborn seizures, levetiracetam dramatically reduces convulsions when compared to phenobarbitone. It was discovered that none of the therapy techniques had any negative effects.},
year = {2025}
}
TY - JOUR T1 - Phenobarbitone Versus Levetiracetam: A Qualified Approach to Initial Neonatal Seizure Management AU - Mohammed Mahfuzur Rahman AU - Abid Hossain Mollah AU - Md Saiful Islam AU - Shaha Mohammad Abdullah Al Baki Y1 - 2025/03/26 PY - 2025 N1 - https://doi.org/10.11648/j.ajp.20251102.11 DO - 10.11648/j.ajp.20251102.11 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 34 EP - 42 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20251102.11 AB - Background: Seizures in newborns are frequent throughout the first month of life and might affect their neurodevelopment. Despite its limited effectiveness and association with cognitive impairment in human subjects, phenobarbitone (PB) is presently the preferred anti-epileptic medication (AED). The use of intravenous levetiracetam to treat seizures in neonates is growing. We have designed a randomized control study using levetiracetam in the initial treatment of acute newborn seizures since there is currently inadequate information on the safety and effectiveness of intravenous levetiracetam in neonates. The objective of the research was to determine if levetiracetam is more applicable than phenobarbitone at reducing convulsions in acute newborn seizures. The procedure of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. The outcome of the research was conducted as a randomized control trial. After meeting the inclusion and exclusion criteria, 100 neonates, ages 0 to 28 days of any sex who were admitted to the special care baby unit (SCABU) of Dhaka Medical College Hospital and had a clinical presentation of neonatal seizures were randomly assigned to levetiracetam (Intervention Phenobarbitone; Control Group = 50). Seizures, the amount of time it took to be seizure-free, and the length of hospital stay were the outcome factors. Regular monitoring was conducted for 48 hours and continued until discharge or death. In conclusion, the study found that when used as a first-line antiepileptic medication to treat acute newborn seizures, levetiracetam dramatically reduces convulsions when compared to phenobarbitone. It was discovered that none of the therapy techniques had any negative effects. VL - 11 IS - 2 ER -
Department of Paediatrics, Dhaka National Medical College Hospital, Dhaka, Bangladesh
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