Management of Seizures in the Newborn

Published by National Neonatology Forum of India on Nov 30, 2023

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Abstract

NNF/2023/CPG/2023.4.0

 

©National Neonatology Forum of India 2023

 

Some rights reserved. This work is licensed under Attribution-NonCommercial-ShareAlike 4.0 International. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ This license requires that you must give credit to the creator. It allows you to distribute, remix, adapt, and build upon the material in any medium or format, for noncommercial purposes only. If you modify or adapt the material, you must license the modified material under identical terms.

 

Suggested citation: Management of Seizures in the Newborn. 25 November 2023. New Delhi: National Neonatology Forum of India; 2023 (NNF/2023/CPG/ 2023.4.0). License: CC BY-NC-SA 4.0 

 

Disclaimers: Due care has been taken to verify the accuracy of all the information in these Clinical Practice Guidelines. However, the contributors, editors, or National Neonatology Forum are not responsible for errors or omissions or any consequences from the application of information provided in this book and give no guarantee concerning the completeness or accuracy of the contents. Application of the information in a situation different from that described in guidelines remains the professional responsibility of the concerned physicians. The guidelines do not endorse any particular brand of equipment or drug. The contributors, editors, and NNF have no affiliation with any of the companies.

The contributors and editors have made great efforts to ensure that all information is according to currently accepted recommendations. However, given the rapidity with which such information changes, the reader is urged to check the latest updates. Updates as and when they occur, shall be posted on the website of NNF and published in the issues of the official journal of NNF, the Journal of Neonatology.
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

National Neonatology Forum of India

About us: National Neonatology Forum (NNF), established in 1980, is the professional association of neonatologists of India. It currently has more than 9000 members (https://www.nnfi.org/about-us). NNF has been instrumental in bringing up neonatology and neonatal care services in India to the forefront. It is actively involved in advocacy, policy-making, capacity-building, and improving quality of care. One of its important mandates is to draw out evidence-based recommendations for neonatal care at different levels. The members of NNF have developed expertise and experience in using GRADE methodology and have released several clinical practice guidelines over the years which are available online (https://www.nnfi.org/cpg) as well as in Google and Apple Playstores (NNF CPG) as app. 

E-mail: secnnf@nnfi.org

 

Office-bearers 2022:

President: Dr. Siddharth Ramji
President-Elect: Dr. Praveen Kumar
Secretary: Dr. Dinesh Tomar
Past President: Dr. Ranjan Kumar Pejaver
Vice President: Dr. Vikram Dutta
Treasurer: Dr. Surender Bisht
Jt. Secretary: Dr. Dinesh Chirla

 

Office-bearers 2023:

President: Dr. Praveen Kumar
President-Elect: Dr. Sushma Nangia
Secretary: Dr. Surender Bisht
Past President: Dr. Siddharth Ramji
Vice President: Dr. Alok Bhandari
Treasurer: Dr. Amit Upadhyay
Jt. Secretary: Dr. Srinivas Murki
Immediate Past Secretary General: Dr. Dinesh Tomar

Language

en

PICOS

PICO 5.1

Population
Neonate with HIE
Intervention
Prophylactic anti-seizure medication
Comparator
No medication/placebo
Outcomes

PICO 6.1

Population
first-line anti-seizure medication in neonatal seizures
Intervention
(Levetiracetam or Phenytoin or Lorazepam)
Comparator
Phenobarbitone
Outcomes

PICO 6.2

Population
second-line anti-seizure medication in neonatal seizures
Intervention
(Levetiracetam or Phenytoin or Lignocaine or Midazolam)
Comparator
(Comparison drug)
Outcomes

PICO 6.3

Population
third-line anti-epileptic drug in neonatal seizures
Intervention
(Midazolam or Lignocaine or Lorazepam or Clonazepam)
Comparator
(Comparison drug)
Outcomes

PICO 7.1

Population
Neonate (Term/ preterm) with acute symptomatic seizure
Intervention
Continuation of maintenance dose during NICU stay
Comparator
Discontinuation of maintenance dose during NICU stay
Outcomes

PICO 8.1

Population
Neonates on maintenance ASM
Intervention
ASM Continuation beyond discharge
Comparator
ASM Discontinuation before or at discharge
Outcomes

PICO 9.1

Population
Neonate (Term/ preterm) with acute symptomatic seizure on maintenance dose of ASM in NICU
Intervention
Stopping maintenance dose during NICU stay after cessation of clinical seizures
Comparator
Stopping maintenance dose during NICU stay after cessation of electrographic seizures
Outcomes

PICO 11.1

Population
Term and Preterm infants with neonatal seizures
Intervention
Index test - MRI Brain
Comparator
Reference test - Neurodevelopemental assessment at 12-24 months
Outcomes

PICO 11.2

Population
Term and Preterm neonates with neonatal seizures
Intervention
Index test - Cranial ultrasound
Comparator
Reference test - Neurodevelopment assessment @ 12-24 mo
Outcomes

PICO 12.1

Population
Neonates with unexplained recurrent seizures
Intervention
Targeted Gene panel testing /whole exome sequencing
Comparator
Outcomes