Therapeutics in pediatric epilepsy, Part 1: The new antiepileptic drugs and the ketogenic diet.

Abstract:

:Epilepsy is one of the most common and challenging neurologic disorders affecting children. Although various modalities exist to treat pediatric-onset seizures, seizures in 25% of children who are diagnosed as having epilepsy remain refractory to available therapies. Of the 8 new antiepileptic drugs (AEDs) (felbamate, gabapentin, lamotrigine, topiramate, tiagabine, levetiracetam, oxcarbazepine, and zonisamide), all but 2 (zonisamide and levetiracetam) have received Food and Drug Administration approval for adjunctive use in the pediatric population. However, most of the new AEDs used in adults have also been used in children, beyond the AEDs' approved indications. The ultimate goal of patient management is to choose the therapeutic option that provides the best chance of improving the patient's quality of life. Issues that relate to treatment choice include the likelihood of seizure recurrence, type and severity of seizures, available AED efficacies and toxicities, need for hematologic monitoring, ease of dosing, underlying medical conditions, medication interactions, urgency of initiating therapy, and cost. In this review, we discuss these issues for each of the 8 new AEDs; we also discuss the ketogenic diet and briefly review the older AEDs. Knowledge of the available AEDs will enable the practitioner to choose the best drug or drugs for individual patients.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Jarrar RG,Buchhalter JR

doi

10.4065/78.3.359

keywords:

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

359-70

issue

3

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)62056-9

journal_volume

78

pub_type

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