title: Current role of rufinamide in the treatment of childhood epilepsy: literature review and treatment guidelines.
abstract: OBJECTIVE
  The literature on the efficacy and safety of rufinamide in childhood-onset epilepsy syndromes currently includes approximately 600 paediatric patients. This paper summarizes the views of a panel of experienced European epileptologists with regard to the current role of rufinamide in the treatment of childhood epilepsies.
  
  
  RESULTS
  Rufinamide is effective in decreasing the seizure frequency in the Lennox-Gastaut syndrome (LGS), especially tonic and atonic seizures. It might consequently be preferred to other drugs as a second-line treatment for LGS when drop-attacks are frequent. The mean responder rate in the published studies is 38% with seizure freedom achieved in 2.4% of patients. Rufinamide has shown some efficacy in epileptic encephalopathies other than LGS. It can be also effective as adjunctive therapy in children and adolescents with drug-resistant partial seizures. The available data suggest that rufinamide has an acceptable risk/benefit ratio with quite a low risk of aggravating seizures. Common adverse effects (somnolence, nausea and vomiting) are usually mild and self-limiting; they are more frequently observed during titration than in the maintenance phase, suggesting that low escalation rates might be associated with fewer adverse effects. Rufinamide appears to have a favourable cognitive profile compared with other antiepileptic drugs.
  
  
  CONCLUSIONS
  Rufinamide is only approved for adjunctive treatment of seizures associated with LGS in children 4 years of age and older. There are very few data on rufinamide treatment at the onset of LGS or early in the course of the disorder; whether early treatment will improve outcome has yet to be determined.
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy.
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.affiliation: South Essex Partnership University NHS Foundation Trust, Bedfordshire, United Kingdom.
authors.forename: Frank
authors.initials: F
authors.lastname: Besag
authors.affiliation: Neurology Unit, "Bambino Gesù" Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cusmai
authors.affiliation: Inserm U1129, Neuropediatrics Department, Necker-Enfants Malades Hospital, APHP, Paris Descartes University, CEA, Orsay, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dulac
authors.affiliation: Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy-Center for Children and Adolescents, Vogtareuth, Germany; Paracelsus Medical University, Salzburg, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kluger
authors.affiliation: Department of Systems Medicine, Child Neurology and Psychiatry Unit, Tor Vergata University Hospital of Rome, Italy.
authors.forename: Romina
authors.initials: R
authors.lastname: Moavero
authors.affiliation: Centre de Reference Epilepsies Rares, Inserm U1129, Neuropediatrics Department, Necker-Enfants Malades Hospital, APHP, Paris Descartes University, CEA, Orsay, France.
authors.forename: Rima
authors.initials: R
authors.lastname: Nabbout
authors.affiliation: Danish Epilepsy Centre, Dianalund, Denmark.
authors.forename: Marina
authors.initials: M
authors.lastname: Nikanorova
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisani
authors.affiliation: Department of Pediatrics, University of Perugia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
authors.affiliation: Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy-Center for Children and Adolescents, Vogtareuth, Germany.
authors.forename: Celina
authors.initials: C
authors.lastname: von Stülpnagel
authors.affiliation: Department of Systems Medicine, Child Neurology and Psychiatry Unit, Tor Vergata University Hospital of Rome, Italy. Electronic address: curatolo@uniroma2.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Curatolo
mesh_terms: D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000592:standards* / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D014230:Triazoles / Q000493:pharmacokinetics / Q000592:standards* / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014230:Triazoles; C079703:rufinamide
keywords: Antiepileptic drug interactions; Epileptic encephalopathy; Focal seizures; Lennox–Gastaut syndrome; Paediatric epilepsy; Rufinamide