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Gabapentin in childhood epilepsy: a prospective evaluation of efficacy and safety
E Korn-Merker1, P Borusiak, H E Boenigk
1Kinderklinik Kidron, Epilepsiezentrum Bethel, Bielefeld, Germnany. kme@neuro.mara.de
Insights
Gabapentin (GBP) was evaluated for pediatric partial epilepsy. While generally safe, gabapentin showed disappointing efficacy in reducing refractory partial seizures in children.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Pharmacology
Background:
- Refractory partial epilepsy in children presents significant treatment challenges.
- Exploring novel antiepileptic drugs is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the efficacy and safety of gabapentin (GBP) as an add-on therapy for pediatric partial epilepsy.
- To determine the effectiveness of GBP in reducing seizure frequency in children with refractory epilepsy.
Main Methods:
- A prospective, open-label, add-on study was conducted.
- 52 children and adolescents with refractory partial seizures participated.
- Gabapentin was administered alongside existing antiepileptic drugs.
Main Results:
- Gabapentin was generally well-tolerated, with doses ranging from 26-78 mg/kg/day.
- Seizure frequency remained unchanged in 65% of patients.
- An initial benefit (seizure reduction ≥50%) was observed in 29% of patients, but tolerance developed in most.
Conclusions:
- Gabapentin demonstrates a favorable safety profile in pediatric patients.
- The efficacy of gabapentin for refractory partial seizures in children was found to be disappointing.
- Further research may be needed to identify optimal treatment strategies for this population.
Purpose:
To evaluate the efficacy and safety of gabapentin (GBP) in partial epilepsy in children.
Methods:
We performed a prospective open label add-on study in 52 children and adolescents (age 1.8-17.5 years, mean 11.1 years) with refractory partial seizures. Gabapentin was added to one other baseline drug and the efficacy was rated according to seizure type and frequency.
Results:
The GBP dose ranged from 26 to 78 mg/kg per day (mean 52 mg/kg per day) and was well tolerated in most patients. The seizure frequency remained unchanged in 34 patients (65%). We saw a provocation of seizures in three children (6%). Initially 15 patients (29%) benefited from GBP: five (10%) with a seizure reduction of 50-74%, seven (13%) with a reduction of 75-99% and three (6%) became seizure free. All but three experienced a development of tolerance within the next weeks to months.
Conclusions:
Although gabapentin seems also to be safe in children, the efficacy in refractory partial seizures was disappointing.