Efficacy of levetiracetam in neonatal seizures, a prospective open label comparative study

Objective: This study compares the efficacy of levetiracetam with phenobarbital in early onset seizures in term, late preterm neonates. Design: Prospective randomized, open label comparative study. Setting: study was carried out in tertiary care teaching hospital of south India. Participants: 78 terms, and late preterm neonates admitted in NICU with neonatal seizures. Intervention: Neonates with seizures, were randomized into 2 groups to receive levetiracetam or phenobarbital as 1st line anti consultant in each group. Results: As 1st line anti epileptic drug (AED) levetiracetam (LEV) was effective in 16 patients (41%), and phenobarbital was effective in19 patients (48.7%), where P value was not significant. But mortality was more in phenobarbital group with death of 10 patients (25.6%), and in LEV group death was only in 3 patients (7.7%) statistically significant (P value of 0.033). Conclusion: levetiracetam and phenobarbital attained seizure control in less than 50% patients, both were equally effective, levetiracetam as 1st line anticonvulsant in early neonatal seizures leads to early seizure control and less mortality than use of phenobarbital.