Abstract
Ninety-one newborn babies had a continuous record of the electroencephalogram (EEG) while receiving intensive care. Seizures occured in 50% and after parental consent 40 entered a randomised trial of 4 anticonvulsants. The loading doses were: phenobarbitone 20mgs/kg, phenytoin 30mgs/kg, clonazepam 0.25mgs, sodium valproate lOmgs/kg. A polygraphic record of physiological variables was made during the infusion and for the next 24 hours. The continuous EEG was maintained for 5 days after treatment. The groups were similar for birthweight and gestational age. Frequency and duration of seizure was decreased by all drugs but phenytoin was the most effective. The median time to control seizures ranged from 18.8 hr (phenytoin) to 120 hr (phenobarbitone and clonazepam). Heart rate, blood pressure and intracranial pressure varied widely after all 4 drugs. Cardiac depression was particularly noticed in asphyxiated babies with myocardial ischaemia. These data suggest that the potentially adverse effects of high doses of anti-convulsants must be balanced against the benefits ot early effective control.
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Wilkinson, A., Rochefort, M. PHENYTOIN REDUCES FREQUENCY AND DURATION OF NEONATAL SEIZURES IN THE NEWBORN: A RANDOMISED TRIAL OF FOUR ANTICONVULSANTS. Pediatr Res 26, 522 (1989). https://doi.org/10.1203/00006450-198911000-00138
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DOI: https://doi.org/10.1203/00006450-198911000-00138