Efficacy and safety of felbamate in children with refractory epilepsy
Eli Heyman1, Noa Levin2, Eli Lahat1
1Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
Insights
Felbamate therapy effectively reduced seizures in 58% of children with drug-resistant epilepsy. Early felbamate initiation is recommended for refractory epilepsy cases, showing good efficacy and safety.
Area of Science:
- Pediatric Neurology
- Epileptology
- Pharmacotherapy
Background:
- Many children with epilepsy remain seizure-free despite new antiepileptic drugs.
- Uncontrolled seizures and side effects persist in a significant patient population.
Purpose of the Study:
- To evaluate the efficacy and safety of felbamate in pediatric patients with drug-resistant epilepsy.
Main Methods:
- Retrospective chart review of patients treated with felbamate.
- Analysis of seizure frequency before and after felbamate initiation at maximal dosage.
- Video-electroencephalogram (EEG) recordings were reviewed.
Main Results:
- Fifty pediatric patients with a mean epilepsy duration of 3.4 years were included.
- 58% of patients experienced at least a 50% reduction in seizure frequency.
- 44% reported side effects, with no cases of aplastic anemia or liver failure.
Conclusions:
- Felbamate is often initiated after numerous other antiepileptic drugs (AEDs).
- Earlier use of felbamate is suggested due to its demonstrated efficacy and safety profile in refractory epilepsy.
- The study supports considering felbamate earlier in treatment algorithms for pediatric epilepsy.
Background:
Despite the introduction of multiple new antiepileptic drugs in the past two decades, many patients with epilepsy continue to experience uncontrolled seizures or significant side effects.
Aim:
To present our experience with felbamate therapy in children with drug-resistant epilepsy.
Methods:
We retrospectively reviewed the medical charts and video-EEG recordings of all patients receiving felbamate until May 2012. Efficacy was determined according to seizure frequency during the week prior to treatment initiation and the week after the maximal dosage of felbamate was reached.
Results:
Fifty patients (34 boys) aged 4 months to 17 years (mean--5.5 years) were identified. Nearly third of the patients had Lennox-Gastaut syndrome. Mean epilepsy duration was 3.4 years (range--1 month to 13 years). The mean number of previous antiepileptic drugs was 7.5. The mean duration of follow-up was 1.1 years. Seizure frequency decreased by at least 50% in 29 (58%) patients. Side effects were reported in 22 (44%) patients, none of them included aplastic anemia or liver failure. In the responder group, the maximal dose of felbamate was lower and the patients were older compared to non-responders.
Conclusions:
Despite current recommendations, felbamate is initiated following multiple AEDs. Based on its efficacy and safety data, earlier initiation of felbamate is recommended in children with refractory epilepsy.
More Related Videos
Related Concept Videos
01:14Antiepileptic Drugs: Glutamate Antagonists
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:08Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...