Percutaneous endoscopic gastrostomy for refractory epilepsy and medication refusal.

Area of Science:

• Pediatric Neurology
• Gastroenterology
• Epilepsy Management

Background:

• Current guidelines for percutaneous endoscopic gastrostomy (PEG) placement prioritize enteral feeding.
• PEG placement may offer benefits in medication adherence for specific pediatric conditions.
• Refractory epilepsy in children presents challenges with oral medication administration.

Purpose of the Study:

• To evaluate the efficacy of PEG tube placement for antiepileptic drug (AED) administration in children with refractory epilepsy.
• To assess the impact of PEG placement on seizure control and quality of life (QOL) in this cohort.
• To explore the feasibility and outcomes of using PEG tubes for medication delivery in non-feeding indications.

Main Methods:

• Retrospective chart review of children with PEG placement for AED therapy across two tertiary pediatric units over 9 years.
• Inclusion criteria focused on children with refractory epilepsy refusing oral medication.
• Parent-reported outcomes on seizure control and QOL were assessed via a structured questionnaire.

Main Results:

• Ten pediatric patients met the inclusion criteria.
• Nine children experienced a decrease in seizure frequency lasting over 12 months post-PEG placement.
• Eight families reported a significant improvement in their child's QOL, with all reporting easier medication administration.

Conclusions:

• PEG tube placement for AED administration is effective in improving seizure control in children with refractory epilepsy.
• This intervention significantly enhances QOL and simplifies medication management for families.
• PEG tubes offer a viable solution for medication delivery in pediatric epilepsy when oral administration is not feasible.