A term newborn develops subtle seizures manifesting as eye deviation and lip smacking at 18 hours of life. Delivery was complicated by fetal distress. Serum glucose and calcium are normal. Which medication is the first-line anticonvulsant for this condition?
- A Lorazepam
- B Levetiracetam
- C Phenobarbital ✓
- D Phenytoin
Correct answer: C. Phenobarbital
Explanation
Phenobarbital is the first-line anticonvulsant for neonatal seizures after excluding metabolic causes like hypoglycemia and hypocalcemia. Lorazepam is used for acute seizure termination but not as first-line maintenance therapy. Phenytoin is second-line due to erratic IV absorption. Levetiracetam is increasingly used off-label but Phenobarbital remains the standard first-line agent in neonatal protocols.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.