title: Efficacy and safety of felbamate in children with refractory epilepsy.
abstract: BACKGROUND
  Despite the introduction of multiple new antiepileptic drugs in the past two decades, many patients with epilepsy continue to experience uncontrolled seizures or significant side effects.
  
  
  OBJECTIVE
  To present our experience with felbamate therapy in children with drug-resistant epilepsy.
  
  
  METHODS
  We retrospectively reviewed the medical charts and video-EEG recordings of all patients receiving felbamate until May 2012. Efficacy was determined according to seizure frequency during the week prior to treatment initiation and the week after the maximal dosage of felbamate was reached.
  
  
  RESULTS
  Fifty patients (34 boys) aged 4 months to 17 years (mean--5.5 years) were identified. Nearly third of the patients had Lennox-Gastaut syndrome. Mean epilepsy duration was 3.4 years (range--1 month to 13 years). The mean number of previous antiepileptic drugs was 7.5. The mean duration of follow-up was 1.1 years. Seizure frequency decreased by at least 50% in 29 (58%) patients. Side effects were reported in 22 (44%) patients, none of them included aplastic anemia or liver failure. In the responder group, the maximal dose of felbamate was lower and the patients were older compared to non-responders.
  
  
  CONCLUSIONS
  Despite current recommendations, felbamate is initiated following multiple AEDs. Based on its efficacy and safety data, earlier initiation of felbamate is recommended in children with refractory epilepsy.
authors.affiliation: Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Heyman
authors.affiliation: Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Levin
authors.affiliation: Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Lahat
authors.affiliation: Department of Pediatric Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Epstein
authors.affiliation: EEG and Epilepsy Unit, Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: revitalgm@hotmail.com.
authors.forename: Revital
authors.initials: R
authors.lastname: Gandelman-Marton
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D000078328:Felbamate; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D048448:Phenylcarbamates / Q000627:therapeutic use*; D011409:Propylene Glycols / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D000927:Anticonvulsants; D048448:Phenylcarbamates; D011409:Propylene Glycols; D000078328:Felbamate
keywords: Efficacy; Epilepsy; Felbamate; Interictal EEG; Safety