Abstracts

Rationale: BECTS is a common but insufficiently studied disorder with multiple potential treatment approaches. Recent assessments of expert treatment approaches (Wheless et al. J Child Neurol 2005;20suppl1; Wheless et al. Epileptic Disord 2007;9:353-412) have yielded variegate results. Methods: An internet-based survey was distributed to the membership of the Child Neurology Society. The questionnaire contained general questions regarding BECTS, a typical patient vignette and questions regarding treatment approach to it, and assessment of professional features of respondents’ background and practice. Results: 252 respondents (about 1/3 of the Society) provided data. While 74% indicated that their first treatment step is not to initiate anticonvulsants, 54% indicated that they do treat BECTS with an anticonvulsant at some point during the course of the disorder, after an average of 3.1 seizures have occurred. Oxcarbazepine and carbamazepine are regarded as first-choice agents, followed by levetiracetam. Clobazam was specifically highlighted by Canadian respondents, and valproate by non-North American respondents. Parental level of comfort was frequently regarded as essential in the process of treatment decision-making. Conclusions: While the great majority of pediatric neurologists do not treat BECTS with an anticonvulsant initially, considerably fewer do not initiate anticonvulsant treatment at any point in the course of the disorder. While carbamazepine and oxcarbazepine still enjoy first-choice status, levetiracetam has become a highly regarded next option. A high number of respondents spontaneously report that parental input is crucial to selection of the treatment approach.