Objective: To probe into the clinical efficacy of levetiracetam in the treatment of neonatal refractory convulsions and influencing factors of prognosis. Methods: Totally 80 neonates with intractable convulsions admitted into Hainan Women and Children’s Medical Center from Apr. 2016 to Mar. 2018 were extracted. The clinical efficacy of levetiracetam in the treatment of neonatal refractory convulsions was analyzed. The children with effective treatment were enrolled in the good prognosis group (n=62)

while the children with ineffective treatment were included in the poor prognosis group (n=18). Logistic multiple regression was used to analyze the influencing factors of prognosis of neonatal refractory convulsions. Results: Eighty children were followed up to one year old

of which 18 cases were ineffective

3 cases were effective

10 cases were markedly effective

49 cases were completely controlled

and the total effective rate was 77.5%. No adverse drug reactions occurred during the follow-up. There were statistically significant differences between the good prognosis group and the poor prognosis group in the duration of convulsions ≥15 min

severe abnormalities in EEG

abnormal brain structure development

congenital metabolic diseases

family history of convulsions and daily seizures (P<0.05). Logistic multiple regression analysis showed that abnormal brain structure and daily seizures were independent risk factors for the prognosis of neonatal refractory convulsions (P<0.05). Conclusion: Levetiracetam has higher safety in the treatment of neonatal refractory convulsions. Severe abnormalities in EEG and daily seizures are independent risk factors that affect neonatal refractory convulsions. EEG can be used as a reference indicator for clinical diagnosis of prognosis.