Presented at the Neonatal Society 2001 Autumn Meeting.

Guerra MP^1,2, Rennie JM¹, Ferrari F², Boylan GB¹, Wilson G¹

¹ Neonatal Intensive Care Unit, Kings College Hospital, London, UK
² Department of Pediatrics and Neonatology, Modena University Hospital, Italy

Purpose: To evaluate the effects of phenobarbitone on the background EEG activity and sleep-state organization of the newborn baby. Background. Phenobarbitone is believed to increase discontinuity and depress the background EEG in babies.

Patients and Methods: We studied 10 babies (GA: 25.5-41.4 weeks, CA: 25.5-42.6 weeks, BW: 700-4.380 g) with seizures whose parents agreed that they could be monitored before treatment was started. Video-EEG-polygraphy was obtained for 1 hour before a loading dose of phenobarbitone (20 mg/Kg) was administered and at 1, 12 and 24 hours after treatment. Phenobarbitone blood levels were tested when possible. Each one hour EEG period was analysed for electrographic seizures, behavioural states (Awake, Quiet-Active-Indeterminate sleep) and continuity-discontinuity of the background EEG activity (interburst intervals of the discontinuous EEG).

Results: All babies studied had seizures, electroclinical or electrographic only. Phenobarbitone did not cause an alteration of the rest activity cycles or behavioural states in any baby. The EEG performed one hour after phenobarbitone administration showed more continuous activity in 4 babies, unchanged in 5 and less continuous in only one baby. Most of the babies had an increase of the continuity of the EEG and a better sleep-state organization 12 or 24 hours after treatment. 

Figure: Background EEG before and after phenobarbitone treatment.

Conclusions: We conclude that a loading dose of phenobarbitone does not alter the continuity of the EEG or the sleep-state organization of babies.