Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

Question  Is discontinuation of antiseizure medication (ASM) after resolution of acute symptomatic neonatal seizures and prior to discharge from the hospital associated with functional neurodevelopment or epilepsy at 24 months?

Findings  In this comparative effectiveness study of 303 children with neonatal seizures from 9 centers, 64% had ASM maintained at hospital discharge. No difference was found between ASM maintenance and discontinuation groups in functional neurodevelopment or epilepsy; 13% of children developed epilepsy, including more than one-third with infantile spasms.

Meaning  These results support discontinuing ASMs for most neonates with acute symptomatic seizures prior to discharge from the hospital, an approach that may represent an evidence-based change in practice for many clinicians.

Article: Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

Editorial: Discontinuing Antiseizure Medication in Neonates With Acute Symptomatic Seizures—Primum non nocere.
Payne ET, Wirrell EC. JAMA Neurol. Published online May 24, 2021. doi:10.1001/jamaneurol.2021.1218