Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Tania Sofia Leano Martins, Ana Vilan and Hercilia Guimaraes
Centro Hospitalar Sao Joao, Portugal
Scientific Tracks Abstracts: Pediat Therapeut
Introduction: Neonatal convulsions, with an incidence of 1.8-3.5/1000, are the most common symptoms of neurological dysfunction and may result from functional organic or metabolic disorders. Phenobarbital remains first therapeutic line drug with less than 50% effectiveness. Aim: Aim of this study is to determine etiology, complementary means of diagnosis, treatment performed with special attention to the use of lidocaine as drugs of 3rd or 4th line and its efficacy in refractory seizures. Methods: A retrospective review of refractory seizures admitted to the neonatal intensive care unit of a tertiary hospital in Portugal between 2009 and 2015. Results: Seven newborns (5M/2F) were diagnosed with refractory seizures (one preterm). Delivery dystocia em 6. Average birth weight was 3177 g. Perinatal asphyxia is the main cause in (3/7), ischemic/hemorrhagic stroke in 2, hypoxia associated to a cardiopulmonary disease and one KCNQ2 gene mutation in 1 case. Imaging and electrophysiological studies were performed in all cases. First line drug was phenobarbital in all cases; 2nd line midazolam 5/7 and levetiracetam and phenytoin 1/7; 3rd line lidocaine in 5/7 and levetiracetam and clobazam 1/7, 4th line levetiracetam 3/5 and midazolam and lidocaine 1/5; 5th line thiopental 2/3 and lidocaine 1/3. Lidocaine was not associated with cardiac electrical changes and resulted in seizure control in 3/7. All infants underwent EEG control and kept antiepileptic therapy to discharge. Conclusions: The use of lidocaine resulted in a moderate control (42% crises) without cardiac effects. Lidocaine should therefore be considered earlier in the treatment of seizures in the neonatal period.
Tania Sofia Leano Martins has completed her Medical Schooling from Medical School of Porto with 15 values and now is pursuing Pediatrics Specialty. She is a Trainer of advanced support of pediatric life as part of the Portuguese pediatric resuscitation group and Volunteer Teacher of pre-graduated Pediatrics practical and theory classes of Master’s degree in Medicine from Oporto Medical Schools. She has attended several courses with evaluation like 11th European Post-graduate course in Neonatal and Pediatric Intensive Care. She has presented several clinical studies in national and international conferences and published in the form of book chapter themes: Tuberculosis in pediatrics age and Neutropenia in Pediatrics.