title: Rufinamide for the treatment of epileptic spasms.
abstract: OBJECTIVE
  The purpose of this study was to determine the safety and efficacy of rufinamide for treatment of epileptic spasms.
  
  
  METHODS
  We retrospectively reviewed patients treated with rufinamide for epileptic spasms from January 2009 to March 2010. Age, presence of hypsarrhythmia, change in seizure frequency following rufinamide initiation, and side effects were assessed. Patients who had a ≥ 50% reduction in spasm frequency were considered responders.
  
  
  RESULTS
  Of all 107 children treated with rufinamide during the study period, 38 (36%) had epileptic spasms. Median patient age was 7 years (range: 17 months to 23). One patient had hypsarrhythmia at the time of treatment with rufinamide, and 9 other patients had a history of hypsarrhythmia. Median starting dose of rufinamide was 9 mg/kg/day (range: 2-18) and median final treatment dose was 39 mg/kg/day (range: 8-92). All patients were receiving concurrent antiepileptic drug therapy, with the median number of antiepileptic drugs being 3 (range: 2-6). Median duration of follow-up since starting rufinamide was 171 days (range: 10-408). Responder rate was 53%. Median reduction in spasm frequency was 50% (interquartile range=-56 to 85%, P<0.05). Two patients (5%) achieved a >99% reduction in spasms. Rufinamide was discontinued in 7 of 38 patients (18%) because of lack of efficacy, worsening seizures, or other side effects. Minor side effects were reported in 14 of 38 patients (37%).
  
  
  CONCLUSIONS
  Rufinamide appears to be a well-tolerated and efficacious adjunctive therapeutic option for children with epileptic spasms. A prospective study is warranted to validate our observations.
authors.affiliation: Department of Neurology, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: H E
authors.initials: HE
authors.lastname: Olson
authors.forename: T
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: M
authors.initials: M
authors.lastname: Vendrame
authors.forename: A
authors.initials: A
authors.lastname: Poduri
authors.forename: M
authors.initials: M
authors.lastname: Takeoka
authors.forename: A M
authors.initials: AM
authors.lastname: Bergin
authors.forename: M H
authors.initials: MH
authors.lastname: Libenson
authors.forename: F H
authors.initials: FH
authors.lastname: Duffy
authors.forename: A
authors.initials: A
authors.lastname: Rotenberg
authors.forename: D
authors.initials: D
authors.lastname: Coulter
authors.forename: B F
authors.initials: BF
authors.lastname: Bourgeois
authors.forename: S V
authors.initials: SV
authors.lastname: Kothare
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014230:Triazoles; C079703:rufinamide