OXCARBAZEPINE IN THE TREATMENT OF EARLY-CHILDHOOD EPILEPSY

Very little data are available on the usefulness of oxcarbazepine in y oung children with epilepsy From January 1991 through October 1994, we treated 53 children under age ? years with oxcarbazepine. The mean fo llow-up with oxcarbazepine treatment was 13 months. Etiology was sympt omatic in 39, cryptogenic in 12, and idiopathic in 2 children. Forty-t hree children had previously been intractable to one or more antiepile ptic drugs (including carbamazepine in 30 patients) and two had carbam azepine hypersensitivity. The age at onset of oxcarbazepine therapy ra nged from 0.6 to 6.9 years (mean, 3.9 yr). The mean maximum oxcarbazep ine dose was 50 mg/kg/day (range, 21-86 mg/kg/day). Of the children wi th localization-related epilepsy, 12 of 44 (27%) became seizure free a nd an additional 16 of 44 (36%) had an at least 50% reduction of seizu res. Five of nine children with generalized epilepsy also had some ben efit but none became seizure free. In the 33 children with at least 50 % seizure reduction, the mean effective dose and trough serum level of the active metabolite monohydroxycarbazepine were 47 mg/kg/day (range , 21-75 mg/kg/day) and 91 mu mol/L (range, 42-130 mu mol/L), respectiv ely. Efficacy was transient in 4 children; side effects were observed in 17 children (32%); in 9 (17%) of whom, they led to dose reduction o r discontinuation. Oxcarbazepine appears to be an effective and well-t olerated drug for localization-related early childhood epilepsy. Young children need a higher dose per body weight than adults.