Seizures after neonatal hypoxia are difficult to treat. A recent antiepileptic safety and dose-finding study examined phenobarbital plus bumetanide, but was stopped owing to apparent futility and increased risk of hearing loss. However, this decision could have been overcautious: 0.2 mg/kg bumetanide reduced seizure burden, and might not have increased hearing loss.
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References
Miller, S. P. et al. Seizure-associated brain injury in term newborns with perinatal asphyxia. Neurology 58, 542–548 (2002).
van Rooij, L. G., van den Broek, M. P., Rademaker, C. M. & de Vries, L. S. Clinical management of seizures in newborns: diagnosis and treatment. Paediatr. Drugs 15, 9–18 (2013).
Pressler, R. M. et al. Bumetanide for the treatment of seizures in newborn babies with hypoxic ischaemic encephalopathy (NEMO): an open-label, dose finding, and feasibility phase 1/2 trial. Lancet Neurol. 14, 469–477 (2015).
Bittigau, P. et al. Antiepileptic drugs and apoptotic neurodegeneration in the developing brain. Proc. Natl Acad. Sci. USA 99, 15089–15094 (2002).
Cleary, R. T. et al. Bumetanide enhances phenobarbital efficacy in a rat model of hypoxic neonatal seizures. PLoS ONE 8, e57148 (2013).
Sullivan, J. E., Witte, M. K., Yamashita, T. S., Myers, C. M. & Blumer, J. L. Dose-ranging evaluation of bumetanide pharmacodynamics in critically ill infants. Clin. Pharmacol. Ther. 60, 424–434 (1996).
Zohar, S. & O'Quigley, J. Optimal designs for estimating the most successful dose. Stat. Med. 30, 4311–4320 (2006).
Bennet, L., Dean, J. M., Wassink, G. & Gunn, A. J. Differential effects of hypothermia on early and late epileptiform events after severe hypoxia in preterm fetal sheep. J. Neurophysiol. 97, 572–578 (2006).
Smit, E. et al. Factors associated with permanent hearing impairment in infants treated with therapeutic hypothermia. J. Pediatr. 163, 995–1000 (2013).
Wood, T. & Thoresen, M. Physiological responses to hypothermia. Semin. Fetal Neonatal Med. 20, 87–96 (2015).
Acknowledgements
We thank L. Walløe for help with assessing the statistical methods used in the trial. We thank the Norwegian and German Research Councils for their support.
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Thoresen, M., Sabir, H. Neonatal seizures still lack safe and effective treatment. Nat Rev Neurol 11, 311–312 (2015). https://doi.org/10.1038/nrneurol.2015.74
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DOI: https://doi.org/10.1038/nrneurol.2015.74
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