Affiliations: Department of Neurology, Children's Hospital Boston
and Harvard Medical School, Boston, MA, USA
Note: [] Correspondence: Janet Soul, MD, CM, FRCPC, Department of
Neurology, Fegan 1106, Children's Hospital, 300 Longwood Avenue, Boston, MA
02115, USA. Tel.: +1 617 355 8994; Fax: +1 617 730 0279; E-mail:
janet.soul@childrens.harvard.edu
Abstract: Novel medications to treat neonatal seizures have been the subject
of numerous recent basic science research and clinical papers describing the
potential and need for more effective and safe antiepileptic drugs (AEDs) for
this unique population. This interest has been fueled in part by the notion
that seizures, particularly when refractory, likely contribute to brain injury,
later epilepsy and neurodevelopmental impairments. The population of newborns
with seizures presents unique challenges, because of the often significant
differences in the pharmacokinetics, safety and efficacy of medications when
compared with older children and adults. Bumetanide and topiramate are two
novel AEDs that have mechanisms of action uniquely suited to suppressing
seizures in the newborn brain, with promising basic science data supporting
their use in human newborns. Furthermore, these novel medications offer the
potential of neuroprotective effects when used to treat refractory seizures
caused by acute insults to the neonatal brain. The available data regarding the
mechanism of action, pharmacokinetics, and safety of these two AEDs will be
described, as well as the data needed to bring these two agents into routine
use in the human newborn with seizures.
