Gabapentin in the treatment of refractory partial epilepsy in children with intellectual disability

Twenty-six children with intellectual disability and six normal children, a ll suffering from refractory partial seizures, received open-label gabapent in (range= 10-50 mg kg(-1) day(-1); mean = 26.7 mg kg(-1) day(-1)) as an ad d-on medication to their antiepileptic drug regimen. Mean seizure frequency during baseline was 9.5 seizures per week. Both groups had a significant r eduction in seizure frequency. Response scores and response ratios did not differ between the intellectually disabled and normal groups (1.67 +/- 0.67 and 1.25 +/- 0.69, P= 0.697, and -0.400 +/- 0.089 and -0.283 +/- 0.159, P= 0.961, respectively). Behavioural side-effects were more likely to occur i n patients with intellectual disability in comparison with the mentally nor mal group (P= 0.0107). in the present patient population, patients younger than 10 years of age, all of whom had intellectual disability, were more li kely to have side-effects than those older than 10 years of age. Observed a dverse effects, which were generally mild, occurred in patients with baseli ne intellectual disability, attention deficit disorder and behavioural prob lems. Behavioural adverse effects warranted discontinuation of the medicati on in only three patients. The severity of intellectual disability (mild ve rsus moderate or severe) did not affect the extent of the response or the o ccurrence of side-effects. It is concluded that gabapentin is equally effec tive as an add-on medication against partial seizures in patients with or w ithout intellectual disability. However, children with intellectual disabil ity who also are less than 10 years of age with baseline attention deficit appear to be at a higher risk of behavioural side-effects.