title: Efficacy of felbamate in the treatment of intractable pediatric epilepsy.
abstract: The antiepileptic drug felbamate has demonstrated efficacy against a variety of seizure types in the pediatric population, particularly seizures associated with Lennox-Gastaut syndrome. Postmarketing experience, however, revealed serious idiosyncratic adverse effects not observed during clinical trials, including aplastic anemia and liver failure. As a result, many physicians have been hesitant to prescribe felbamate. This retrospective study evaluated the efficacy of felbamate in a pediatric population with intractable epilepsy. Of 38 patients, 22 had Lennox-Gastaut syndrome (58%); 6 had myoclonic-astatic epilepsy of Doose (16%); 5 had symptomatic generalized epilepsy, not otherwise specified (13%); and 5 had symptomatic localization-related epilepsy (13%). Most patients had multiple seizure types and had been tried on a variety of antiepileptic medications. With felbamate treatment, 6 patients (16%) became seizure free, including 4 of the 6 patients with myoclonic-astatic epilepsy of Doose; 24 patients (63%) had a greater than 50% reduction in seizure frequency. In this population felbamate appeared to be safe, with minimal adverse effects. The study is limited by the small number of patients and by its retrospective nature, but nonetheless adds to the evidence that felbamate is an important antiepileptic drug for medically refractory epilepsy in children and is well tolerated with few adverse effects.
authors.affiliation: Department of Neurology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI, USA. mzupanc@mcw.edu
authors.forename: Mary L
authors.initials: ML
authors.lastname: Zupanc
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roell Werner
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schwabe
authors.forename: Sunila E
authors.initials: SE
authors.lastname: O'Connor
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Marcuccilli
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Hecox
authors.forename: Maria S
authors.initials: MS
authors.lastname: Chico
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Eggener
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy*; D000078328:Felbamate; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D048448:Phenylcarbamates / Q000627:therapeutic use*; D011409:Propylene Glycols / Q000627:therapeutic use*; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D048448:Phenylcarbamates; D011409:Propylene Glycols; D000078328:Felbamate