Reducing the Percent of Surviving Infants with Acute Symptomatic Seizures Discharged on Anti-Seizure Medication

Abstract Objective: To evaluate the impact of inclusion of an ASM weaning protocol in a neonatal seizure pathway on the percent of infants discharged on ASMs. Study Design: This cohort study included surviving infants with acute symptomatic seizures treated with ASMs. We evaluated infants in 2 epochs, pre- and post-implementation of the ASM weaning protocol. The primary outcome was discharge on ASM. Results: Of 116 included infants, the percent of infants discharged on ASMs was 69% in epoch 1 versus 34% in epoch 2 (p<0.001). There was no significant difference between epochs in recurrence of seizures after discharge by 1 year of age (p=0.125). There was an annual decrease in the percent of infants discharged on ASM for both delivery and referral NICUs. Conclusion: Inclusion of a formal ASM weaning protocol as part of an institutional seizure pathway reduced percent of infants with acute symptomatic seizures discharged on ASM.