Effects of various antiepileptic drugs in benign infantile seizures with mild gastroenteritis

Abstract

Purpose: This study sought to deter mine the appr opr iate choice of antiepileptic dr ugs (AEDs) for seizures during the acute phase in patients with benign infantile seizures with mild gastroenteritis (BISMG). Methods: We retrospectively investigated the efficacy and dose of AEDs for BISMG by reviewing the medical records of 42 patients diagnosed with BISMG. In this study, AEDs were regarded as effective when seizures ceased for >24 h after administration. Results: AEDs were administered to 39 of 42 patients (92.9%). Carbamazepine was effective in 21 of 21 patients (100.0%), phenytoin/fos-phenytoin in three of four patients (75.0%), midazolam in one of two patients (50.0%), lidocaine in one of two patients (50.0%), and diazepam in 13 of 36 patients (36.1%). Intravenous diazepam was effective in seven of 11 patients (63.6%) and suppository diazepam in 10 of 25 patients (40.0%). The median dose of carbamazepine was 5.0 mg/kg/day (range, 3.0-5.0 mg/kg/day) and the median duration of medication was 1 day (range, 1-5 days). Conclusion: Tr eatment for 1 day with low-dose carbamazepine was effective for BISMG. Phenytoin/fosphenytoin and intravenous diazepam, not but suppository diazepam, were also effective. We recommend 1 day of treatment with low-dose carbamazepine as the first-line treatment for BISMG. The unnecessary use of AEDs for BISMG should be avoided after the acute phase because seizures in BISMG rarely recur.

Update on benign convulsions with mild gastroenteritis

“…81) Similarly, another study showed that 1-day treatment with low-dose carbamazepine was effective for CwG. 82) Some studies demonstrated that fosphenytoin and chloral hydrate are also effective for CwG. 83,84) In addition, a recent study showed that a single dose of lacosamide was well tolerated in patients with CwG.…”

“…Another study reported that 1-day treatment with carbamazepine or lidocaine effectively treated clustering seizures in CwG [ 81 ]. Similarly, another study showed that 1-day treatment with low-dose carbamazepine was effective for CwG [ 82 ]. Some studies demonstrated that fosphenytoin and chloral hydrate are also effective for CwG [ 83 , 84 ].…”