{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:04:21Z","timestamp":1784642661905,"version":"3.55.0"},"reference-count":36,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,13]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of neonatal mortality and long-term neurodevelopmental impairment worldwide. Neonatal seizures are common in HIE and are associated with adverse outcomes. While antiseizure medications are routinely used for treatment, their prophylactic use in the absence of clinically evident seizures remains controversial, with limited consensus and variable clinical practices. Therefore, this review will map the existing evidence concerning the utilisation of antiseizure medication for prophylaxis among neonates with HIE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The review will follow the Joanna Briggs Institute scoping review methodology and be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search will be conducted across various scientific databases, including PubMed, Embase, Scopus and Web of Science, guided by the Population, Intervention, Concept and Context framework, starting between October and November 2026. The review will consider studies on the prophylactic use of antiseizure medication among neonates with HIE. The collected search results will be organised and uploaded to Covidence, where duplicates will be removed, and titles and abstracts will be screened. Search and screening processes have not yet started.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This will be a secondary study using already published information; therefore, ethical approval was not sought. All studies included in this review will be cited accordingly, as attributed to the publication licence. The data gathered will be summarised in a scoping review and submitted for publication in an international peer-reviewed journal. Datasets shall also be made publicly available in a data repository, such as the Open Science Framework.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-120449","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:40:59Z","timestamp":1784641259000},"page":"e120449","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prophylactic antiseizure medication administration practices in neonates with hypoxic-ischaemic encephalopathy: a scoping review protocol"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct02160171","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02431780","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Lillian Edith","family":"Nalwanga","sequence":"first","affiliation":[{"name":"Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4126-4056","authenticated-orcid":false,"given":"Innocent","family":"Ayesiga","sequence":"additional","affiliation":[{"name":"Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom Didimus","family":"Ediamu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Moroto Regional Referral Hospital, Moroto, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026072106402846000_16.7.e120449.1","doi-asserted-by":"crossref","unstructured":"Naburi HE , Pillay S , Houndjahoue F , et al . A survey on the diagnosis and management of neonatal hypoxic ischaemic encephalopathy in sub-saharan Africa. Sci Rep 2024;14. doi:10.1038\/s41598-024-72849-3","DOI":"10.1038\/s41598-024-72849-3"},{"key":"2026072106402846000_16.7.e120449.2","doi-asserted-by":"crossref","first-page":"114411","DOI":"10.1016\/j.jpeds.2024.114411","article-title":"Assessing Early Severity of Hypoxic-Ischemic Encephalopathy: The Role of Electroencephalogram Background in Addition to Sarnat Exam","volume":"277","author":"Cornet","year":"2025","journal-title":"J Pediatr"},{"key":"2026072106402846000_16.7.e120449.3","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2023-326102"},{"key":"2026072106402846000_16.7.e120449.4","article-title":"Comparison of Modified Sarnat Staging and Thompson Score in Neonatal Hypoxic-Ischemic Encephalopathy","volume":"18","author":"Gohatre","year":"2026","journal-title":"Cureus"},{"key":"2026072106402846000_16.7.e120449.5","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/S2352-4642(23)00296-1","article-title":"Temporal evolution of electrographic seizures in newborn infants with hypoxic-ischaemic encephalopathy requiring therapeutic hypothermia: a secondary analysis of the ANSeR studies","volume":"8","author":"Pavel","year":"2024","journal-title":"Lancet Child Adolesc Health"},{"key":"2026072106402846000_16.7.e120449.6","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-300716"},{"key":"2026072106402846000_16.7.e120449.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.07.015"},{"key":"2026072106402846000_16.7.e120449.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-022-02398-w"},{"key":"2026072106402846000_16.7.e120449.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-017-0876-y","article-title":"Prevalence, severity and early outcomes of hypoxic ischemic encephalopathy among newborns at a tertiary hospital, in northern Tanzania","volume":"17","author":"Simiyu","year":"2017","journal-title":"BMC Pediatr"},{"key":"2026072106402846000_16.7.e120449.10","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17745"},{"key":"2026072106402846000_16.7.e120449.11","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.clp.2024.04.013","article-title":"Treating seizures and improving newborn outcomes for infants with hypoxic-ischemic encephalopathy","volume":"51","author":"Anwar","year":"2024","journal-title":"Clin Perinatol"},{"key":"2026072106402846000_16.7.e120449.12","unstructured":"Grayson C , Harden C . Treatment of seizures in the neonate: guidelines and consensus-based recommendations. 2023."},{"key":"2026072106402846000_16.7.e120449.13","doi-asserted-by":"crossref","DOI":"10.1186\/s40348-025-00195-z","article-title":"Treatment of neonatal seizures: from guidelines to precision therapy","volume":"12","author":"Falsaperla","year":"2025","journal-title":"Mol Cell Pediatr"},{"key":"2026072106402846000_16.7.e120449.14","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s13312-019-1586-3","article-title":"Levetiracetam versus Phenobarbitone in Neonatal Seizures - A Randomized Controlled Trial","volume":"56","author":"Gowda","year":"2019","journal-title":"Indian Pediatr"},{"key":"2026072106402846000_16.7.e120449.15","doi-asserted-by":"publisher","DOI":"10.5863\/1551-6776-29.5.482"},{"key":"2026072106402846000_16.7.e120449.16","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1007\/s00431-023-04864-x","article-title":"Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures - a pilot randomized control trial in developing country setup","volume":"182","author":"Gyandeep","year":"2023","journal-title":"Eur J Pediatr"},{"key":"2026072106402846000_16.7.e120449.17","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-3182","article-title":"Levetiracetam Versus Phenobarbital for Neonatal Seizures: A Randomized Controlled Trial","volume":"145","author":"Sharpe","year":"2020","journal-title":"Pediatrics"},{"key":"2026072106402846000_16.7.e120449.18","doi-asserted-by":"crossref","first-page":"111104","DOI":"10.1016\/j.jocn.2025.111104","article-title":"Time to response and predictors of seizure response to phenobarbitone therapy among neonates admitted with hypoxic-ischemic encephalopathy at Nekemte Comprehensive Specialized Hospital, Ethiopia","volume":"134","author":"Hailu","year":"2025","journal-title":"J Clin Neurosci"},{"key":"2026072106402846000_16.7.e120449.19","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1038\/pr.2017.266","article-title":"The effects of adding prophylactic phenobarbital to therapeutic hypothermia in the term-equivalent hypoxic-ischemic rat","volume":"83","author":"Krishna","year":"2018","journal-title":"Pediatr Res"},{"key":"2026072106402846000_16.7.e120449.20","doi-asserted-by":"crossref","DOI":"10.3390\/ijms22137121","article-title":"Treating Seizures after Hypoxic-Ischemic Encephalopathy-Current Controversies and Future Directions","volume":"22","author":"Zhou","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2026072106402846000_16.7.e120449.21","doi-asserted-by":"crossref","unstructured":"Sanchez-Brualla I , Ghosh A , Gibatova VA , et al . Phenobarbital does not worsen outcomes of neonatal hypoxia on hippocampal LTP on rats. Front Neurol 2023;14. doi:10.3389\/fneur.2023.1295934","DOI":"10.3389\/fneur.2023.1295934"},{"key":"2026072106402846000_16.7.e120449.22","doi-asserted-by":"crossref","unstructured":"Quinlan SMM , Rodriguez-Alvarez N , Molloy EJ , et al . Complex spectrum of phenobarbital effects in a mouse model of neonatal hypoxia-induced seizures. Sci Rep 2018;8. doi:10.1038\/s41598-018-28044-2","DOI":"10.1038\/s41598-018-28044-2"},{"key":"2026072106402846000_16.7.e120449.23","doi-asserted-by":"crossref","unstructured":"Schmidt R , Welzel B , Merten A , et al . Temporal development of seizure threshold and spontaneous seizures after neonatal asphyxia and the effect of prophylactic treatment with midazolam in rats. Exp Neurol 2025;383. doi:10.1016\/j.expneurol.2024.115042","DOI":"10.1016\/j.expneurol.2024.115042"},{"key":"2026072106402846000_16.7.e120449.24","doi-asserted-by":"crossref","unstructured":"Young L , Berg M , Soll R , et al . Prophylactic barbiturate use for the prevention of morbidity and mortality following perinatal asphyxia. Cochrane Database Syst Rev 1996;2016. doi:10.1002\/14651858.CD001240.pub3","DOI":"10.1002\/14651858.CD001240.pub3"},{"key":"2026072106402846000_16.7.e120449.25","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1002\/jrsm.1731","article-title":"Automation tools to support undertaking scoping reviews","volume":"15","author":"Khalil","year":"2024","journal-title":"Res Synth Methods"},{"key":"2026072106402846000_16.7.e120449.26","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00167"},{"key":"2026072106402846000_16.7.e120449.27","unstructured":"Mpofana N , Chibi B , Gqaleni N , et al . PRISMA-ScR-Fillable-Protocol Checklist, Available: https:\/\/figshare.com\/articles\/onlineresource\/PRISMA-ScR-Fillable-Protocol_Checklist_pdf\/23811105\/1"},{"key":"2026072106402846000_16.7.e120449.28","doi-asserted-by":"publisher","DOI":"10.3233\/EFI-180221"},{"key":"2026072106402846000_16.7.e120449.29","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.11124\/JBIES-20-00570","article-title":"Methodological quality, guidance, and tools in scoping reviews: a scoping review protocol","volume":"20","author":"Pollock","year":"2022","journal-title":"JBI Evid Synth"},{"key":"2026072106402846000_16.7.e120449.30","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s40272-017-0250-4","article-title":"Pharmacotherapy for Seizures in Neonates with Hypoxic Ischemic Encephalopathy","volume":"19","author":"Yozawitz","year":"2017","journal-title":"Paediatr Drugs"},{"key":"2026072106402846000_16.7.e120449.31","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.pediatrneurol.2024.01.009","article-title":"Epilepsy Incidence and Developmental Outcomes After Early Discontinuation of Antiseizure Medication in Neonatal Hypoxic-Ischemic Encephalopathy","volume":"153","author":"Jagadish","year":"2024","journal-title":"Pediatr Neurol"},{"key":"2026072106402846000_16.7.e120449.32","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2022-324612"},{"key":"2026072106402846000_16.7.e120449.33","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.39604","article-title":"Effect of Treatment of Clinical Seizures vs Electrographic Seizures in Full-Term and Near-Term Neonates: A Randomized Clinical Trial","volume":"4","author":"Hunt","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026072106402846000_16.7.e120449.34","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1080\/00207454.2019.1687469","article-title":"Efficacy and safety of levetiracetam in the off-label treatment of neonatal seizures","volume":"130","author":"Liu","year":"2020","journal-title":"Int J Neurosci"},{"key":"2026072106402846000_16.7.e120449.35","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1177\/08830738221086107","article-title":"Efficacy of Levetiracetam and Phenobarbital as First-Line Treatment for Neonatal Seizures","volume":"37","author":"Verwoerd","year":"2022","journal-title":"J Child Neurol"},{"key":"2026072106402846000_16.7.e120449.36","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s12098-023-04905-1","article-title":"Levetiracetam versus Phenobarbitone for Management of Neonatal Seizures: A Systematic Review and Meta-analysis","volume":"92","author":"Kumar","year":"2025","journal-title":"Indian J Pediatr"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-120449","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:41:14Z","timestamp":1784641274000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-120449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,21]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2026-120449"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-120449","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}