Treating Seizures after Hypoxic-Ischemic Encephalopathy—Current Controversies and Future Directions

Show simple item record Zhou, Kelly Q McDouall, Alice Drury, Paul P Lear, Christopher A Cho, Kenta HT Bennet, Laura Gunn, Alistair J Davidson, Joanne O 2021-08-15T22:49:12Z 2021-08-15T22:49:12Z 2021-7-1
dc.identifier.citation International journal of molecular sciences 22(13) Jul 2021
dc.identifier.issn 1661-6596
dc.description.abstract <jats:p>Seizures are common in newborn infants with hypoxic-ischemic encephalopathy and are highly associated with adverse neurodevelopmental outcomes. The impact of seizure activity on the developing brain and the most effective way to manage these seizures remain surprisingly poorly understood, particularly in the era of therapeutic hypothermia. Critically, the extent to which seizures exacerbate brain injury or merely reflect the underlying evolution of injury is unclear. Current anticonvulsants, such as phenobarbital and phenytoin have poor efficacy and preclinical studies suggest that most anticonvulsants are associated with adverse effects on the developing brain. Levetiracetam seems to have less potential neurotoxic effects than other anticonvulsants but may not be more effective. Given that therapeutic hypothermia itself has significant anticonvulsant effects, randomized controlled trials of anticonvulsants combined with therapeutic hypothermia, are required to properly determine the safety and efficacy of these drugs. Small clinical studies suggest that prophylactic phenobarbital administration may improve neurodevelopmental outcomes compared to delayed administration; however, larger high-quality studies are required to confirm this. In conclusion, there is a distinct lack of high-quality evidence for whether and to what extent neonatal seizures exacerbate brain damage after hypoxia-ischemia and how best to manage them in the era of therapeutic hypothermia.</jats:p>
dc.language en
dc.publisher MDPI AG
dc.relation.ispartofseries International Journal of Molecular Sciences
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.subject Science & Technology
dc.subject Life Sciences & Biomedicine
dc.subject Physical Sciences
dc.subject Biochemistry & Molecular Biology
dc.subject Chemistry, Multidisciplinary
dc.subject Chemistry
dc.subject hypoxic-ischemic encephalopathy
dc.subject asphyxia
dc.subject seizures
dc.subject antiepileptic drugs
dc.subject anticonvulsants
dc.subject therapeutic hypothermia
dc.subject phenobarbital
dc.subject levetiracetam
dc.subject BRAIN
dc.subject MECHANISMS
dc.subject NEWBORNS
dc.subject BURDEN
dc.subject INJURY
dc.subject 0399 Other Chemical Sciences
dc.subject 0604 Genetics
dc.subject 0699 Other Biological Sciences
dc.title Treating Seizures after Hypoxic-Ischemic Encephalopathy—Current Controversies and Future Directions
dc.type Journal Article
dc.identifier.doi 10.3390/ijms22137121
pubs.issue 13
pubs.begin-page 7121
pubs.volume 22 2021-07-21T03:59:12Z
dc.rights.holder Copyright: The author en
pubs.publication-status Published online
dc.rights.accessrights en
pubs.subtype Review
pubs.subtype Journal
pubs.elements-id 858537
dc.identifier.eissn 1422-0067
pubs.number ARTN 7121 2021-7-1

Files in this item

Find Full text

This item appears in the following Collection(s)

Show simple item record


Search ResearchSpace