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Abstrakt
Phenobarbitone for Seizures in Newborns: Controversies
Priyanka Gupta and Amit Upadhyay
Clinically, seizures are defined as a paroxysmal alteration of neurological function, that is, motor, behavioral and/or autonomic function. Seizures are the most important signal of neurological disease in the neonatal period. They occur in 1-5% of newborns. The incidence is higher in this period than in any other period of life. It is important to treat seizures because of their potential negative effects on respiratory function, circulation, cerebral metabolism and brain development. When an aEEG is used, cessation of all electrical seizure activity should be the goal of therapy. Although mortality due to neonatal seizures has decreased over the years from 40% to about 20%, the prevalence of long-term neurodevelopmental sequelae has remained almost unchanged at about 30%. This means that the treatment of neonatal seizures is still inappropriate and there is room for improvement. Current guidelines are based on limited clinical data. Controversies regarding the best first-line agent, the second-line agent, the dose and duration, and the monitoring of drug levels continue.