Treatment of "benign" partial epilepsies of childhood, including atypical forms

In a retrospective study the results of therapy in 60 children with so-called benign partial epilepsies are reported. It has been shown that the assessment of the therapeutic effect has to include the EEG, especially in epilepsies with atypical course. Carbamazepine has no effect on the EEG, in epilepsies with atypical course (atypical benign partial epilepsy, Landau-Kleffner syndrome, epilepsy with continuous spikes and waves during slow sleep [CSWS]) carbamazepine usually has no effect either on the seizures or on the EEG, on the contrary, in some cases both may even get worse. In our experience, the drug of choice in all types of benign childhood epilepsy is sulthiame, if necessary in combination with clobazam. Other drugs previously administered, including carbamazepine, should be dropped quickly. If the treatment with sulthiame or sulthiame/clobazam in children with atypical course is not effective, ACTH-therapy should be considered as soon as possible. These results should be confirmed in a prospective randomized study.