Does One More Medication Help? Effect of Adding Another Anticonvulsant in Childhood Epilepsy

Desai, Jay; Mitchell, Wendy G.

doi:10.1177/0883073810380916

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…This is illustrated by the fact that an increase from 2 to 3 agents led to a significant response in fewer than 15% of patients. 31 In our cohort, no serious adverse events had been documented and none of the patients had to discontinue corticosteroid treatment due to drug intolerability. In the studies of Kramer and Charuvani, however, cushingoid appearance developed in more than half and behavioural deterioration in more than 10% of patients.…”

Section: Discussionmentioning

confidence: 65%

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Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood seizures and a review of other corticosteroid treatments

Bakker

Catsman‐Berrevoets

Neuteboom

2015

European Journal of Paediatric Neurology

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Section: Discussionmentioning

confidence: 65%

“…To illustrate this, a placebo effect of 5e25% has been reported in studies on anticonvulsant drugs. 31 Although this evaluation was neither placebo controlled, nor blinded, medication was not considered effective until seizure reduction was more than 50%.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood seizures and a review of other corticosteroid treatments

Bakker

Catsman‐Berrevoets

Neuteboom

2015

European Journal of Paediatric Neurology

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“…Moreover, pediatric patients with intractable epilepsy were reviewed in a neurology clinic from July 1 2004 to December 31 2007. [28] The study concluded that the addition of a second AED resulted in the reduction of seizure frequency, but this was much less possible with the addition of a third AED.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of seizure frequency among Malaysian children diagnosed with structural– metabolic epilepsy

Salih

Bahari

Shafie

et al. 2012

Journal of Neurosciences in Rural Practice

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Introduction:Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes.Materials and Methods:A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form.Results:Seizure frequency showed no significant association with patient's demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 ± 56.66, 10.94 ± 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001).Conclusion:Among children with structural–metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients.

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Childhood Epilepsy and Autism Spectrum Disorders: Psychiatric Problems, Phenotypic Expression, and Anticonvulsants

Robinson

2012

Neuropsychol Rev

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Epilepsy and autism spectrum disorders (ASDs) frequently co-occur during childhood, however, the characteristics of psychiatric or behavioural problems in these children remains largely unknown. This article contributes to these discussions by reporting on the prevalence and presentation of psychiatric or behavioural problems in children with epilepsy and ASDs, as well as on the use of anticonvulsants in these children. The current evidence suggests that children with epilepsy and ASDs may present with a distinct clinical profile, with a greater number of developmental difficulties, and a more severe expression of the ASD phenotype that can not solely be accounted for by level of intellectual functioning. Positive effects of anticonvulsants on behavioural symptoms associated with ASDs were also reported, though pharmacoresistance and a lack of clear treatment guidelines may contribute to an elevated risk of adverse side effects. In relation to clinical presentation and management there is a need for careful consideration of potential interaction effects between disorder specific factors (e.g., age of seizure onset/ASD diagnosis), cognitive characteristics (e.g., intellectual functioning, memory), and psychosocial variables (e.g., coping strategies). Ultimately however, many conclusions are tentative and this review highlights the need for more empirically validated research on children with epilepsy and ASDs.

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Does One More Medication Help? Effect of Adding Another Anticonvulsant in Childhood Epilepsy

Abstract: Worthwhile seizure reduction is reasonably likely with the addition of a second anticonvulsant, but much less likely with the addition of third anticonvulsant.

Cited by 6 publications

References 14 publications

Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood seizures and a review of other corticosteroid treatments

Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood seizures and a review of other corticosteroid treatments

Characteristics of seizure frequency among Malaysian children diagnosed with structural– metabolic epilepsy

Childhood Epilepsy and Autism Spectrum Disorders: Psychiatric Problems, Phenotypic Expression, and Anticonvulsants

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