Oxcarbazepine - Experiences in 142 Children and Adolescents with Difficult To Treat Epilepsies.
Abstract number :
2.249
Submission category :
Year :
2001
Submission ID :
300
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
E. Korn-Merker, Dr. Med., Klinik Kidron, Epilepsie Zentrum Bethel, Bielefeld, Germany; M. Holtmann, Klinik Kidron, Epilepsie Zentrum Bethel, Bielefeld, Germany; M. Krause, Dr. Med., Klink Kidron, Epilepsie Zentrum Bethel, Bielefeld, Germany; J. Opp, Dr. M
RATIONALE: The therapeutical spectrum of Oxcarbazepine (OCBZ) is comparable to that of Carbamazepine (CBZ). Especially in combination with other antiepileptic drugs (AED) its tolerability seems to be better than that of CBZ. There is no [dsquote]Epoxide-Problem[dsquote] which is well known as the reason for unwanted side effects in CBZ.
METHODS: From 1995 until 2000 142 patients have been treated with OCBZ in our hospital: 75 boys, 67 girls, mean age 9;7 y (Range 1 mo-15;10y) suffering from difficult to treat epilepsies (symptomatic focal 89, cryptogenic focal 26, symptomatic focal 12, Lennox-Gastaut-Syndrome 6, others 9). One patient have had OCBZ-monotherapy, all others had combinations with other AED mostly Valproate (VPA). They have been treated with 2-15 AED (mean 6,6) before without effect. 58 patients have been switched directly from CBZ to OCBZ. Follow-up was from 5 mo - 4;10y.
RESULTS: 52 children benefited from OCBZ: 15 were seizure free at the time of discharge, 18 showed a seizure-reduction of 75-99%, 10 had 50-75%, 9 had 50% seizure reduction but fewer seizure intensity or less unwanted side effects. That effect has been stable in about 2/3 of all patients during the follow up. Mean dose of OCBZ was 44,7 mg/kg. Severe unwantd side effects have been seen. Allergic reaction in 6 patients, provocation of seizures in 5, behavioral disturbance in 4 and hyponatremia in 1.
CONCLUSIONS: Even in patients with multipharmacoresistant epilepsies OCBZ is effective. 10,5% of our patients became seizure free. More than one third benefited. Severe unwanted side effects are less often than in CBZ especially given in combination with VPA. In some patients the effect was less during the follow up but that was not as often as we know this from benzodiazepines or vigabatrine.