Efficacy and Safety of Using Levetiracetam and Phenobarbitone for the Treatment of Neonatal Seizure due to Hypoxic Ischemic Encephalopathy

Background: Timely diagnosis and management of a patient of neonatal seizure are challenging due to limited resources and adverse effects produced by the drugs used. Phenobarbitone is conventionally being using in pediatric department, while Levetiracetam is the newer one. This study compared the efficacy and safety between Phenobarbitone and Levetiracetam in treating neonatal seizure patients. Methods: This open-labelled comparative study conducted in 100 cases of neonatal seizure in Sylhet Women’s Medical College Hospital, Sylhet, Bangladesh. All the patients were full-term with normal birth-weight baby. They were grouped equally into Group-A (n = 50, Levetiracetam treated group) and Group-B (n = 50, Phenobarbitone treated group) by lottery method. Both Levetiracetam and Phenobarbitone were given intravenously at the dose of 20 mg/kg body-weight over 30 minutes initially. Based on the requirement, further administration was given with a maximum dose of 40 mg/kg body-weight. Results: The response rate was 82% in Levetiracetam and 26% in Phenobarbitone treatment group. However, Levetiracetam treatment took significant shorter time to control the seizure event compared to the Phenobarbitone (11.44±11.17 minutes and 18.23±4.12 minutes respectively, p=<0.001). Adverse effects also observed significantly less in Levetiracetam treated group compared to the Phenobarbitone treated group (3/50 and 20/50 respectively, p=0.003) in this study. Conclusion: Levetiracetam treatment found significantly more effective and relatively safe compared to the Phenobarbitone in the treatment of neonatal seizure.