LOW-RISK OF SEIZURE RECURRENCE AFTER EARLY WITHDRAWAL OF ANTIEPILEPTIC TREATMENT IN THE NEONATAL-PERIOD

The risk of seizure recurrence within the first year of life was evalu ated in infants with neonatal seizures diagnosed with a combination of clinical signs, amplitude-integrated electroencephalogram (EEG) monit oring, and standard EEG. Fifty eight of 283 (4.5%) neonates in tertiar y level neonatal intensive care had seizures. The mortality in the inf ants with neonatal seizures was 36.2%. In 31 surviving infants antiepi leptic treatment was discontinued after one to 65 days (median 4.5 day s). Three infants received no antiepileptic treatment, two continued w ith prophylactic antiepileptic treatment. Seizure recurrence was prese nt in only three cases (8.3%) - one infant receiving prophylaxis, one treated for 65 days, and in one infant treated for six days. Owing to the small number of infants with seizure recurrence, no clinical featu res could be specifically related to an increased risk of subsequent s eizures. When administering antiepileptic treatment, one aim was to ab olish both clinical and electrographical seizures. Another goal was to minimise the duration of treatment and to keep the treatment as short as possible. It is suggested that treating neonatal seizures in this way may not only reduce the risk of subsequent seizure recurrence, but may also minimise unnecessary non-specific prophylactic treatment for epilepsy.