Clobazam as add-on therapy for temporal lobe epilepsy and hippocampal sclerosis.
BACKGROUND
Clobazam is a benzodiazepine with known antiepileptic action; however, it is not considered first line therapy in the treatment of epilepsy. The objective of this study was to evaluate the efficacy of clobazam as add-on therapy in adults with temporal lobe epilepsy associated with MRI evidence of hippocampal sclerosis (HS).


METHODS
This is a retrospective study, conducted at our epilepsy clinic which evaluated clobazam as add-on therapy in patients with temporal lobe epilepsy and MRI signs of HS. Clobazam was prescribed based on the minimum effective dose up to the maximum tolerated dose.


RESULTS
Seventy-eight patients met the inclusion criteria (51 women), ages ranging from 16 to 76 years old (mean=42.2). Dosage of clobazam ranged from 5 to 60 mg/day (mean=22.6 mg/day). Clobazam was used from one month to eight years (mean=29 months). Sixteen (20.5%) patients were seizure-free, 20 (25.5%) had more than 75% improvement in seizure control, eight (10%) had more than 50% and 20 (26%) were non responders to clobazam. In 14 (18%) we could not determine seizure frequency during follow-up. The improvement in seizure control lasted for more than one year in 30 (68%) patients.


CONCLUSIONS
Our data suggest that clobazam should be considered as add-on therapy in the treatment of patients with temporal lobe epilepsy associated with MRI signs of HS.
Montenegro
Maria Augusta
MA
Department of Neurology, University of Campinas, Cidade Universitária Zeferino Vaz, SP, Brazil.
Ferreira
Claudio Meilman
CM
Cendes
Fernando
F
Li
Li M
LM
Guerreiro
Carlos A M
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D000078306:Clobazam; D004359:Drug Therapy, Combination; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012598:Sclerosis / Q000188:drug therapy* / Q000473:pathology
D000927:Anticonvulsants; D001569:Benzodiazepines; D000078306:Clobazam