| Title: |
Long‐term safety of early discontinuation of antiseizure medication after resolution of acute provoked neonatal seizures |
| Authors: |
Glass, Hannah C; Numis, Adam L; Soul, Janet S; Wusthoff, Courtney J; Lemmon, Monica E; Chu, Catherine J; Massey, Shavonne L; Thomas, Cameron; Anwar, Tayyba; Berl, Madison M; Larson, Jennifer G; Sturza, Julie; Annis, Dana; Rogers, Elizabeth E; Franck, Linda S; McCulloch, Charles E; Shellhaas, Renée A |
| Source: |
Epilepsia |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2026 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
3213 Paediatrics (for-2020); 32 Biomedical and Clinical Sciences (for-2020); Brain Disorders (rcdc); Infant Mortality (rcdc); Neurodegenerative (rcdc); Perinatal Period - Conditions Originating in Perinatal Period (rcdc); Epilepsy (rcdc); Pediatric Research Initiative (rcdc); Clinical Research (rcdc); Neurosciences (rcdc); Neurological (hrcs-hc); 3 Good Health and Well Being (sdg); antiseizure medication (ASM); electroencephalography (EEG); epilepsy; hypoxic-ischemic encephalopathy (HIE); neonatal encephalopathy; neonatal seizures; neurocritical care; seizure; hypoxic–ischemic encephalopathy (HIE); 1103 Clinical Sciences (for); 1109 Neurosciences (for); Neurology & Neurosurgery (science-metrix); 3202 Clinical sciences (for-2020); 3209 Neurosciences (for-2020) |
| Description: |
OBJECTIVE: To assess long-term safety of antiseizure medication (ASM) discontinuation after resolution of acute provoked neonatal seizures and prior to hospital discharge. METHODS: Prospective, observational, comparative effectiveness cohort study of neonates with acute provoked seizures born from July 2015 to March 2018, and followed until September 2024, at nine U.S. Neonatal Seizure Registry centers with Level IV neonatal intensive care units and Level IV pediatric epilepsy programs. Duration of ASM treatment was quantified as (1) discontinuation before discharge from the neonatal seizure admission or (2) maintenance at the time of hospital discharge. Outcomes were adjusted for propensity to receive ASM at discharge. Propensity for ASM maintenance was defined among enrolled participants by a logistic regression model including seizure etiology, gestational age, therapeutic hypothermia, worst electroencephalography (EEG) background, days of EEG seizures, and discharge neurological exam (all p ≤ .1 in a joint model, except etiology, which was included for face validity). The primary outcome was non-inferiority of cognition (Wechsler Preschool and Primary Scale of Intelligence assessed at age 5-6 years). Secondary outcomes were non-inferiority of functional development (Vineland Adaptive Behavior Scale, 3rd Edition, assessed at 3-8 years) and post-neonatal epilepsy (assessed at 1-8 years). RESULTS: Among 284 children with at least one follow-up, outcomes were similar in the discontinued vs maintained ASM groups for full-scale IQ at age 5 years (adjusted difference +10 points), functional development at ages 3-8 years (adjusted difference 0 points), and post-neonatal epilepsy at ages 1-8 years (adjusted hazard ratio .93, 95% confidence interval [CI] .48-1.80). SIGNIFICANCE: Prolonged administration of ASM for several months after resolution of acute provoked neonatal seizures may expose infants to unnecessary medications. These results provide additional evidence for safety of discontinuing ASM for most neonates ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt9mf6b4k1; https://escholarship.org/uc/item/9mf6b4k1; https://escholarship.org/content/qt9mf6b4k1/qt9mf6b4k1.pdf |
| DOI: |
10.1002/epi.70192 |
| Availability: |
https://escholarship.org/uc/item/9mf6b4k1; https://escholarship.org/content/qt9mf6b4k1/qt9mf6b4k1.pdf; https://doi.org/10.1002/epi.70192 |
| Rights: |
CC-BY-NC-ND |
| Accession Number: |
edsbas.C7436263 |
| Database: |
BASE |