Aggravation of seizures and/or EEG features in children treated with oxcarbazepine monotherapy.
OBJECTIVE
Exacerbation of epilepsy may occur following initiation of therapy with antiepileptic drugs (AEDs). The aim of this study is to analyze the clinical and EEG characteristics of a group of pediatric patients with worsening of seizures and/or EEG deterioration while on oxcarbazepine (OXC).


METHODS
A retrospective analysis of a clinical database was performed to identify patients with epilepsy treated with OXC over the past 3 years. History, neurological examination, and EEG findings were reviewed to identify any who had developed exacerbation of seizures or new abnormalities on EEG.


RESULTS
Of 290 patients on OXC, we identified 12 patients with new onset seizures, all with initial normal neurological exam and normal EEG, who developed either worsening of preexisting seizures, new seizure types, and/or EEG deterioration following introduction of OXC monotherapy. EEG changes were primarily characterized by new onset of generalized epileptiform activity not reported on the initial baseline EEG. Following substitution of OXC with a broad spectrum AED, significant improvement of seizure control and improvement in the EEG was observed.


CONCLUSIONS
These findings suggest that OXC can aggravate seizures and/or worsen EEG features in children. Following initiation of therapy with OXC, monitoring of patients with follow-up EEGs may be important, especially in patients who do not show adequate response to therapy.
Vendrame
Martina
M
Department of Pediatrics, Division of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Erie Avenue at Front Street, Philadelphia, PA 19134, U.S.A.
Khurana
Divya S
DS
Cruz
Marcos
M
Melvin
Joseph
J
Valencia
Ignacio
I
Legido
Agustin
A
Kothare
Sanjeev V
SV
D000208:Acute Disease; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000187:drug effects* / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D000078330:Oxcarbazepine; D012189:Retrospective Studies; D016896:Treatment Outcome
D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine