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Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Cenobamate's Efficacy for Seizure Treatment in Tuberous Sclerosis Complex
Gewalin Aungaroon1, Alexander Cooke2, David Ritter1
1Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Pediatrics, University of Cincinnati, Cincinnati, Ohio.
Pediatric Neurology
|October 19, 2024
Summary
Cenobamate (CBM) showed seizure reduction in tuberous sclerosis complex (TSC) patients, but responder rates were lower than expected. Challenges in tolerating CBM and managing concurrent medications require further investigation for improved treatment retention.
Area of Science:
- Neurology
- Epileptology
- Pharmacology
Background:
- Epilepsy management in tuberous sclerosis complex (TSC) presents significant challenges.
- The efficacy of cenobamate (CBM) in TSC patients remains largely uncharacterized.
Purpose of the Study:
- To evaluate the efficacy and tolerability of adjunctive cenobamate (CBM) in patients with tuberous sclerosis complex (TSC).
Main Methods:
- Retrospective review of 54 TSC patients treated with adjunctive CBM.
- Seizure frequencies were compared at baseline and 3, 6, 12, and 18-month follow-ups.
- Treatment retention, responder rates, and side effects were assessed.
Main Results:
- Significant seizure reduction was observed in 64.8% of patients, with a mean reduction of 61.5% to 74.6%.
- Responder rates (≥50% seizure reduction) ranged from 38.1% to 59.1% over 18 months.
- Common side effects included sedation (42.6%) and behavioral disturbances (24.1%), impacting treatment retention.
Conclusions:
- Adjunctive CBM offers seizure reduction in TSC patients but with lower responder and seizure-free rates compared to general epilepsy populations.
- The unique epileptogenesis in TSC and CBM tolerability issues may contribute to these findings.
- Optimizing concurrent medication adjustments is crucial to improve treatment retention in this cohort.
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