The Impact of Electroencephalographic (EEG) Seizure Treatment in Neonatal Encephalopathy
This is a prospective, randomized, single-center pilot trial of term and near term (≥ 36 weeks gestation) infants with encephalopathy or seizures comparing a "EEG Seizure Treatment Group" or ESG with a "Clinical Seizure Treatment Group" or CSG.
The investigators hypothesize that the accurate detection and treatment of EEG seizures will decrease the seizure burden and improve outcomes in newborn infants with seizures and/or hypoxic-ischemic encephalopathy (HIE).
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||The Impact of Electroencephalographic (EEG) Seizure Treatment in Near Term ≥ 36 Weeks Gestation and Term Infants With Neonatal Encephalopathy|
- Seizure burden [ Time Frame: 2 to 3 years ]
- Presence of a single combined event: death in the first two years of life or moderate or severe disability at 18-24 months [ Time Frame: first two years of life; 18-24 months ]
- Time to seizure cessation [ Time Frame: 2 to 3 years ]
- Number, duration of anticonvulsants used and cumulative dose [ Time Frame: 2 to 3 years ]
- EEG background state [ Time Frame: 2 to 3 years ]
- Time to all per oral feeding [ Time Frame: 2 to 3 years ]
- Duration of hospital stay [ Time Frame: 2 to 3 years ]
- MRI measures from the Day #7-10 MRI in survivors [ Time Frame: 2 to 3 years ]
|Study Start Date:||January 2010|
|Study Completion Date:||December 2015|
|Primary Completion Date:||December 2015 (Final data collection date for primary outcome measure)|
Experimental: EEG seizure treatment group
EEG data available to physicians. Treatment based on EEG seizures. Treatment will be dictated by the detailed treatment protocol. Standard antiepileptic medications will be used.
Other: EEG monitoring and treatment of EEG seizures
Seizures will prompt treatment with loading doses of phenobarbital (20mg/kg), fosphenytoin (20mg/kg),and midazolam (0.05mg/kg bolus and .15mg/kg/hr infusion tapered over 48 hours)in that order for persisting seizures.
No Intervention: Clinical Seizure treatment Group
Seizure treatment in this group will be based on standard care - treating clinical seizures only. While EEG data will be collected in this group, the data will not be available to the treating physicians. A one-hour EEG report will be available to the treating team. Continuous EEG monitoring and treatment will only be allowed if the initial EEG shows status.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01027715
|United States, Missouri|
|St. Louis Children's Hospital|
|St. Louis, Missouri, United States, 63110|
|Principal Investigator:||Amit Mathur||Washington University in Saint Louis|