Evidence map›Paper›PMID 41826797›Full record

Observational studyEpilepsia2026

Long-term safety of early discontinuation of antiseizure medication after resolution of acute provoked neonatal seizures.

Hannah C Glass, Adam L Numis, Janet S Soul, Courtney J Wusthoff, Monica E Lemmon, Catherine J Chu, Shavonne L Massey, Cameron Thomas, Tayyba Anwar, Madison M Berl and 7 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Hannah C GlassDepartment of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-3879-1966
Adam L NumisDepartment of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-1594-9812
Janet S SoulDepartment of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-6998-7753
Courtney J WusthoffDepartment of Neurology, University of California Davis, Sacramento, California, USA.ORCID https://orcid.org/0000-0002-1882-5567
Monica E LemmonDepartment of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.ORCID https://orcid.org/0000-0001-6253-775X
Catherine J ChuDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-7670-9313
Shavonne L MasseyDepartment of Neurology, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-8496-221X
Cameron ThomasDepartment of Pediatrics, Division of Neurology, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.ORCID https://orcid.org/0000-0003-1529-2846
Tayyba AnwarDivision of Neurology, Children's National Hospital, Washington, DC, USA.ORCID https://orcid.org/0000-0002-1686-8352
Madison M BerlDivision of Neuropsychology, Children's National Hospital, Washington, DC, USA.ORCID https://orcid.org/0000-0002-2469-1518
Jennifer G LarsonDivision of Rehabilitation Psychology Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0009-0009-3716-0052
Julie SturzaDepartment of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0009-0006-1486-1890
Dana AnnisNSR Parent Partner, Children's National Hospital, Washington, DC, USA.
Elizabeth E RogersDepartment of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-5449-9693
Linda S FranckDepartment of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-4291-9181
Charles E McCullochDepartment of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-1279-6179
Renée A ShellhaasDepartment of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0002-3175-3908

Funding

Neonatal Seizure Registry Developmental Functional EValuation (NSR-DEV)R01NS111166 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GLASS, HANNAH CRANLEY, SHELLHAAS, RENEE A. · 2020 to 2023
$4.6M
NINDS NIH HHS R01 NS111166NINDS NIH HHS R01NS111166Patient-Centered Outcomes Research Institute 2015C2-1507-31187
6 · The paper itself

Abstract

objectiveTo assess long-term safety of antiseizure medication (ASM) discontinuation after resolution of acute provoked neonatal seizures and prior to hospital discharge.

methodsProspective, observational, comparative effectiveness cohort study of neonates with acute provoked seizures born from July 2015 to March 2018, and followed until September 2024, at nine U.S. Neonatal Seizure Registry centers with Level IV neonatal intensive care units and Level IV pediatric epilepsy programs. Duration of ASM treatment was quantified as (1) discontinuation before discharge from the neonatal seizure admission or (2) maintenance at the time of hospital discharge. Outcomes were adjusted for propensity to receive ASM at discharge. Propensity for ASM maintenance was defined among enrolled participants by a logistic regression model including seizure etiology, gestational age, therapeutic hypothermia, worst electroencephalography (EEG) background, days of EEG seizures, and discharge neurological exam (all p ≤ .1 in a joint model, except etiology, which was included for face validity). The primary outcome was non-inferiority of cognition (Wechsler Preschool and Primary Scale of Intelligence assessed at age 5-6 years). Secondary outcomes were non-inferiority of functional development (Vineland Adaptive Behavior Scale, 3rd Edition, assessed at 3-8 years) and post-neonatal epilepsy (assessed at 1-8 years).

resultsAmong 284 children with at least one follow-up, outcomes were similar in the discontinued vs maintained ASM groups for full-scale IQ at age 5 years (adjusted difference +10 points), functional development at ages 3-8 years (adjusted difference 0 points), and post-neonatal epilepsy at ages 1-8 years (adjusted hazard ratio .93, 95% confidence interval [CI] .48-1.80). SIGNIFICANCE: Prolonged administration of ASM for several months after resolution of acute provoked neonatal seizures may expose infants to unnecessary medications. These results provide additional evidence for safety of discontinuing ASM for most neonates soon after the resolution of acute provoked seizures-a practice that is recommended in the International League Against Epilepsy (ILAE) guideline for neonatal seizure management.

Indexed as

AnticonvulsantsSeizuresChildChild, PreschoolElectroencephalographyFemaleHumansInfant, NewbornMaleProspective StudiesTreatment InterruptionAnticonvulsantsantiseizure medication (ASM)electroencephalography (EEG)epilepsyhypoxic–ischemic encephalopathy (HIE)neonatal encephalopathyneonatal seizuresneurocritical careseizure

Identifiers

PMID41826797
PMCPMC13285239

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.