DOI: 10.11648/j.ejpm.20261404.14 ISSN: 2330-8230

Injectable Levetiracetam in the Management of Acute Neonatal Seizures: Evidence from Term and Preterm Neonates

Mohammed Rahman, Saiful Islam, Farhana Alam
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Background: Acute neonatal seizures are a neurological emergency and a frequent marker of serious brain injury during the first 28 days of life. Injectable levetiracetam is increasingly used in neonatal units because it can be administered intravenously and has a favorable short-term cardiorespiratory tolerability profile. Objective: To present injectable levetiracetam as a management option for acute neonatal seizures and to describe clinical evidence from term and late-preterm neonates using the author's original clinical dataset. Methods: This original clinical manuscript was revised from the existing word file into an IMRAD format. The clinical data were derived from neonates aged 0-28 days admitted with acute seizures to the Special Care Baby Unit of Dhaka Medical College Hospital. Eligible mature and late-preterm neonates had gestational age above 34 weeks and below 42 weeks and birth weight above 2000 g. Injectable levetiracetam was administered as the active treatment arm, and outcomes were assessed by seizure control, need for additional antiseizure medication, time to seizure control, adverse effects, treatment outcome, and hospital stay. The original randomized dataset included a comparator arm, but the present manuscript is framed around the levetiracetam management profile in term and preterm neonates. Results: Among 50 neonates who received injectable levetiracetam, 44 (88.0%) were term and 6 (12.0%) were preterm. Mean gestational age was 38.00 ± 1.43 weeks and mean birth weight was 2776.00 ± 267.50 g. Seizure control was achieved in 33 neonates (66.0%), while 17 (34.0%) required additional antiseizure medication. Forty neonates (80.0%) achieved seizure control within 12 hours, and the mean time to seizure control was 6.88 ± 15.47 hours. Adverse effects were reported in 5 neonates (10.0%), mainly somnolence and irritability. Mean hospital stay was 6.22 ± 2.20 days. Conclusion: Injectable levetiracetam showed clinically useful seizure control and acceptable short-term tolerability in this cohort of term and late-preterm neonates with acute neonatal seizures. The findings support its role as a structured component of neonatal seizure management, with careful attention to gestational age, renal maturity, seizure etiology, and local neonatal protocols.

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