Background. Phenobarbital (PB) has been traditionally used as the first-line treatment for neonatal seizures. More recently, levetiracetam (LEV) has been increasingly used as a promising newer antiepileptic medication for treatment of seizures in neonates. Objectives. The aim of our study was to compare the effect of PB vs. LEV on short-term neurodevelopmental outcome in infants treated for neonatal seizures. Method. This randomized, one-blind prospective study was conducted on term neonates admitted to the Neonatal Intensive Care Unit of S. Bambino Hospital, University Hospital “Policlinico-Vittorio Emanuele,” Catania, Italy, from February 2016 to February 2018. Thirty term neonates with seizures were randomized to receive PB or LEV; the Hammersmith Neonatal Neurological Examination (HNNE) was used at baseline (T0) and again one month after the initial treatment (T1). Results. We found a significantly positive HNNE score for the developmental outcomes, specifically tone and posture, in neonates treated with LEV. There was no significant improvement in the HNNE score at T1 in the neonates treated with PB. Conclusion. This study suggests a positive effect of levetiracetam on tone and posture in term newborns treated for neonatal seizures. If future randomized-controlled studies also show better efficacy of LEV in the treatment of neonatal seizures, LEV might potentially be considered as the first-line anticonvulsant in this age group.

中文翻译：

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用苯巴比妥与左乙拉西坦治疗的足月新生儿的短期神经发育结果：单中心经验。

背景。苯巴比妥（PB）传统上被用作新生儿癫痫发作的一线治疗。最近，左乙拉西坦 (LEV) 越来越多地被用作一种有前途的新型抗癫痫药物，用于治疗新生儿癫痫发作。目标。我们研究的目的是比较 PB 与 LEV 对接受新生儿惊厥治疗的婴儿短期神经发育结果的影响。方法. 这项随机、单盲前瞻性研究是对 2016 年 2 月至 2018 年 2 月在意大利卡塔尼亚“Policlinico-Vittorio Emanuele”大学医院 S. Bambino 医院新生儿重症监护室收治的足月新生儿进行的。30 名足月新生儿患有癫痫发作随机接受 PB 或 LEV；在基线（T0）和初始治疗后一个月（T1）再次使用 Hammersmith 新生儿神经系统检查（HNNE）。结果。我们发现在接受 LEV 治疗的新生儿中，HNNE 评分显着提高了发育结果，特别是语气和姿势。接受 PB 治疗的新生儿在 T1 时的 HNNE 评分没有显着改善。结论. 这项研究表明左乙拉西坦对接受新生儿癫痫治疗的足月新生儿的语气和姿势有积极影响。如果未来的随机对照研究也显示 LEV 在治疗新生儿癫痫发作方面的疗效更好，则 LEV 可能被视为该年龄组的一线抗惊厥药。