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Anticonvulsant effect of xenon on neonatal asphyxial seizures
  1. Denis Azzopardi1,2,
  2. Nicola J Robertson3,
  3. Andrew Kapetanakis1,
  4. James Griffiths4,
  5. Janet M Rennie5,
  6. Sean R Mathieson3,
  7. A David Edwards1
  1. 1Centre for the Developing Brain, King's College London, London, UK
  2. 2Institute of Clinical Sciences, Imperial College London, London, UK
  3. 3Institute for Women's Health, University College London, London, UK
  4. 4National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
  5. 5Department of Neonatal Medicine, University College Hospital, London, UK
  1. Correspondence to Professor Denis Azzopardi, Centre for the Developing Brain, St Thomas's Hospital, Westminster Bridge Road, London SE1 7EH, UK; d.azzopardi{at}imperial.ac.uk

Abstract

Xenon, a monoatomic gas with very high tissue solubility, is a non-competitive inhibitor of N-methyl-D-aspartate (NMDA) glutamate receptor, has antiapoptotic effects and is neuroprotective following hypoxic ischaemic injury in animals. Xenon may be expected to have anticonvulsant effects through glutamate receptor blockade, but this has not previously been demonstrated clinically. We examined seizure activity on the real time and amplitude integrated EEG records of 14 full-term infants with perinatal asphyxial encephalopathy treated within 12 h of birth with 30% inhaled xenon for 24 h combined with 72 h of moderate systemic hypothermia. Seizures were identified on 5 of 14 infants. Seizures stopped during xenon therapy but recurred within a few minutes of withdrawing xenon and stopped again after xenon was restarted. Our data show that subanaesthetic levels of xenon may have an anticonvulsant effect. Inhaled xenon may be a valuable new therapy in this hard-to-treat population.

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