Abstracts

The objective of this study is to evaluate the efficacy and tolerability of levetiracetam monotherapy in neonates with acute stroke., This is a single center open-label study of 3 neonates (less than 24 hour of age). In all cases, focal seizures were confirmed by EEG. The focal seizures were in all three children the result of an acute perinatal stroke (non hemorrhagic in 2; hemorrhagic in one). A loading dose of 50 mg/kg of levetiracetam was administered through a nasogastric tube while children were actively seizing and only benzodiazepines were given concomitantly. Seizure control and side effects were monitored while on once a day dosing., No patient stopped levetiracetam due to side effect or lack of efficacy. No other anticonvulsant had to be added to the regimen to maintain seizure control. Feeding difficulties were initially seen but cleared after a few days. Levetiracetam level was still high twelve hours after the first dose (50mcg/dL in one child). No other adverse event was observed. All three patients were left without neurological sequellae and the follow-up imaging studies in our patients with acute brain injury showed a complete resolution of their lesion., Levetiracetam given once a day in neonates is well tolerated. We believe that, in neonates with acute stroke, levetiracetam has neuroprotective properties explaining the complete recovery of our patients.,