Antiepileptic Drug Selection in Pediatric Epilepsy

Abstract

This review article presents information concerning treatment options for various pediatric epilepsy syndromes. The decisions made in the selection of antiepileptic drugs are deternined by a number of variables that include, but are exclusive of, risk of seizure recurrence, patient age, epilepsy syndrome, known drug reactions, and prognosis of the epilepsy syndrome. The review discusses issues pertinent to antiepileptic drug selection including simple pharmacokinetic principles, antiepileptic drug formulations, and information concerning clinical studies using some of the antiepileptic drugs. Information is provided concerning the issues of seizure recurrence. Suggested paradigms for antiepileptic drug selection for partial seizures are provided. A table of antiepileptic drug costs is provided for assistance in prescribing and advising families. Psychosocial issues pertinent to the treatment of children are discussed.

A retrospective study on the usage of antiepileptic drugs in Asian children from 2000 to 2009 in the largest pediatric hospital in Singapore

“…VGB was most widely used in children aged 1 to 2 years, and its usage declined rapidly thereafter. In the European countries and Canada, VGB is a first‐line drug for the treatment of West syndrome, especially patients identified with tuberous sclerosis . Our findings echoed the results from the other study that noted VGB as the most prevalent drug in the younger than 2 years age group (0.73 subjects per 1000 person years) among children in UK .…”

Investigation Of Structure-Activity Relationships With Molecular Docking For Some Antiepileptic Drugs And Voltage-Gated Calcium (CaV) Channels

“…Calcium channel blockers; Calcium channels are very important for rhythmic brain activity, especially in the thalamus region. L, N, and T-type calcium channels, especially T-type calcium channels, play a role in absence seizures and their inhibition is important in absence seizures [15]. Voltage-gated calcium channels (CaV) contribute to the general excitability of neurons by transmitting Ca2+ and a small amount of Na+ and play an important role in neuronal firing.…”

Tratamiento nutricional con dieta cetogénica en niños con epilepsia refractaria - revisión narrativa

“…Esta dieta se caracteriza por permitir un mayor aporte de carbohidratos en comparación con la DC clásica, DC con TCM y con la Atkins modificada. Es necesario controlar estrictamente la cantidad de carbohidratos brindados, y escoger alimentos que posean un índice glucémico inferior a 50, prefiriendo alimentos con alto porcentaje de fibra (25,26) .…”

“…Indicada en pacientes entre los 2 y los 6 años. La evidencia muestra que cuando se compara la DC clásica con la dieta Atkins modificada, la respuesta es la esperada; en adolescentes y adultos, se sugiere aumentar proporcionalmente la cantidad de grasa brindada por medio de un preparado líquido similar a la DC clásica al iniciar el tratamiento dietario y durante el primer mes (25) .…”