Abstracts

Rationale: Clobazam, a 1,5 benzodiazepine is used as an adjunctive anti-epileptic drug (AED) for nearly two decades. There is limited data on its efficacy in the long term management of refractory epilepsy. This study was initiated to evaluate long-term effectiveness of Clobazam in patients with refractory epilepsy.Methods: Consecutive patients with medically refractory epilepsy who had received prescriptions for Clobazam over 7 years, were analyzed to identify patients meeting the following criteria: 1 and 2-year retention of the drug; seizure freedom or 50% or 75% reduction in seizure frequency after initiation of AED and major adverse effects necessitating withdrawal of the drug. Results: One hundred and sixty five patients (122:43 M: F) with a mean age of 20.8 +/- 11.6 years and median seizure duration of 8 years (range 1.5 to 39 years) met inclusion criteria. The majority had focal epilepsy syndromes (81%). MRI data on 133 patients disclosed temporal lobe signal changes in 48 (36.09%), extratemporal focal signal changes in 22 (16.55%) and diffuse abnormalities in 41 (30.83%) patients. Seizure freedom reported in 34/155 patients (22%) at 6 months, dropped to 19/155 patients (13%) at 1 year. Seventy-nine patients (51%) experienced at least 50% reduction while 55 patients (35%) reported a 75% reduction in seizure frequency at 1 year. Clobazam retention rates were 94.7% patients at 1 year and in 63% patients at 2 years. An acceptable level of sedation was the only major side effect reported in 23% patients, but this did not necessitate withdrawal in any patient. Conclusions: Despite availability of a large number of new effective anti-epileptic medications, Clobazam remains an effective and well tolerated AED choice for medically refractory epilepsy.