[Long-term efficacy and tolerance of stiripentaol in severe myoclonic epilepsy of infancy (Dravet's syndrome)].
OBJECTIVE
To describe the long term efficacy and tolerance of stiripentol associated with valproate and clobazam in an exhaustive cohort of patients with severe myoclonic epilepsy of infancy (Dravet's syndrome), in which short term efficacy of such a treatment has recently been demonstrated in a placebo-controlled trial.


RESULTS
In 46 patients the frequency and the duration of seizures was significantly reduced (p < 0.001) as well as the number of convulsive status at a median of three-year follow-up. Ten patients were dramatically improved (seizures significantly decreased in number [p = 0.002] and duration [p = 0.002] and status epilepticus disappeared), 20 were moderately improved (seizures significantly decreased in duration [p = 0.001] and status were less numerous), four had no response and efficacy was non evaluable in 12 mainly because of adverse events. Efficacy was better in the youngest patients. The most frequent adverse events were loss of appetite and loss of weight. They could be so severe in patients over 12 years of age that the stiripentol dosage could not be increased to 50 mg kg-1 j-1.


CONCLUSIONS
This follow-up study shows that stiripentol added to valproate and clobazam maintains its efficacy at long term in children with severe myoclonic epilepsy of infancy and suggests that the tritherapy should be introduced as early as possible in these patients in order to suppress the convulsive status epilepticus.
Thanh
T Nguyen
TN
Service de neuropédiatrie, hôpital Saint-Vincent-de-Paul, Assistance publique-Hôpitaux de Paris, 82, avenue Denfert-Rochereau, 75674 Paris, France.
Chiron
C
C
Dellatolas
G
G
Rey
E
E
Pons
G
G
Vincent
J
J
Dulac
O
O
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D001569:Benzodiazepines; D002675:Child, Preschool; D000078306:Clobazam; D004148:Dioxolanes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004831:Epilepsies, Myoclonic / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D004148:Dioxolanes; D001569:Benzodiazepines; D000078306:Clobazam; D014635:Valproic Acid; C021092:stiripentol