Felbamate for pediatric epilepsy—should we keep on using it as the last resort?
IntroductionConcerns regarding felbamate adverse effects restrict its widespread use in children with drug-resistant epilepsy. We aimed to examine the efficacy and safety of felbamate in those children and identify the ones who may benefit most from its use.MethodsWe retrospectively reviewed the med...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.979725/full |
| _version_ | 1797995438571257856 |
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| author | Shira Rabinowicz Shira Rabinowicz Tal Schreiber Gali Heimer Gali Heimer Omer Bar-Yosef Omer Bar-Yosef Andreea Nissenkorn Andreea Nissenkorn Zohar-Dayan E Zohar-Dayan E Leo Arkush Leo Arkush Nasrin Hamed Nasrin Hamed Bruria Ben-Zeev Bruria Ben-Zeev Michal Tzadok Michal Tzadok |
| author_facet | Shira Rabinowicz Shira Rabinowicz Tal Schreiber Gali Heimer Gali Heimer Omer Bar-Yosef Omer Bar-Yosef Andreea Nissenkorn Andreea Nissenkorn Zohar-Dayan E Zohar-Dayan E Leo Arkush Leo Arkush Nasrin Hamed Nasrin Hamed Bruria Ben-Zeev Bruria Ben-Zeev Michal Tzadok Michal Tzadok |
| author_sort | Shira Rabinowicz |
| collection | DOAJ |
| description | IntroductionConcerns regarding felbamate adverse effects restrict its widespread use in children with drug-resistant epilepsy. We aimed to examine the efficacy and safety of felbamate in those children and identify the ones who may benefit most from its use.MethodsWe retrospectively reviewed the medical files of all patients who were treated with felbamate in a tertiary pediatric epilepsy clinic between 2009–2021. Drug efficacy was determined at the first 3 months of treatment and thereafter. Therapeutic response and adverse reactions were monitored throughout the course of treatment.ResultsOur study included 75 children (age 8.9 ± 3.7 years), of whom 53 were treated with felbamate for seizures, 16 for electrical status epilepticus during sleep and 6 for both. The median follow-up time was 16 months (range 1–129 months). The most common cause for epilepsy was genetic (29%). The median number of previous anti-seizure medications was six [4–8]. A therapeutic response ≥50% was documented in 37 (51%) patients, and a complete response in 9 (12%). Nineteen patients (25%) sustained adverse reactions, including three cases of elevated liver enzymes and one case of neutropenia with normal bone marrow aspiration. In all cases, treatment could be continued. All children with intractable epilepsy following herpes encephalitis showed a response to felbamate.ConclusionFelbamate is an efficacious and safe anti-seizure medication in the pediatric population. |
| first_indexed | 2024-04-11T10:00:19Z |
| format | Article |
| id | doaj.art-3924f60a73cc4310b315ceb63f919dab |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T10:00:19Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-3924f60a73cc4310b315ceb63f919dab2022-12-22T04:30:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.979725979725Felbamate for pediatric epilepsy—should we keep on using it as the last resort?Shira Rabinowicz0Shira Rabinowicz1Tal Schreiber2Gali Heimer3Gali Heimer4Omer Bar-Yosef5Omer Bar-Yosef6Andreea Nissenkorn7Andreea Nissenkorn8Zohar-Dayan E9Zohar-Dayan E10Leo Arkush11Leo Arkush12Nasrin Hamed13Nasrin Hamed14Bruria Ben-Zeev15Bruria Ben-Zeev16Michal Tzadok17Michal Tzadok18Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelPediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, IsraelSackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelIntroductionConcerns regarding felbamate adverse effects restrict its widespread use in children with drug-resistant epilepsy. We aimed to examine the efficacy and safety of felbamate in those children and identify the ones who may benefit most from its use.MethodsWe retrospectively reviewed the medical files of all patients who were treated with felbamate in a tertiary pediatric epilepsy clinic between 2009–2021. Drug efficacy was determined at the first 3 months of treatment and thereafter. Therapeutic response and adverse reactions were monitored throughout the course of treatment.ResultsOur study included 75 children (age 8.9 ± 3.7 years), of whom 53 were treated with felbamate for seizures, 16 for electrical status epilepticus during sleep and 6 for both. The median follow-up time was 16 months (range 1–129 months). The most common cause for epilepsy was genetic (29%). The median number of previous anti-seizure medications was six [4–8]. A therapeutic response ≥50% was documented in 37 (51%) patients, and a complete response in 9 (12%). Nineteen patients (25%) sustained adverse reactions, including three cases of elevated liver enzymes and one case of neutropenia with normal bone marrow aspiration. In all cases, treatment could be continued. All children with intractable epilepsy following herpes encephalitis showed a response to felbamate.ConclusionFelbamate is an efficacious and safe anti-seizure medication in the pediatric population.https://www.frontiersin.org/articles/10.3389/fneur.2022.979725/fullfelbamateepilepsyelectrical status epilepticus during sleepherpesdrug resistance |
| spellingShingle | Shira Rabinowicz Shira Rabinowicz Tal Schreiber Gali Heimer Gali Heimer Omer Bar-Yosef Omer Bar-Yosef Andreea Nissenkorn Andreea Nissenkorn Zohar-Dayan E Zohar-Dayan E Leo Arkush Leo Arkush Nasrin Hamed Nasrin Hamed Bruria Ben-Zeev Bruria Ben-Zeev Michal Tzadok Michal Tzadok Felbamate for pediatric epilepsy—should we keep on using it as the last resort? Frontiers in Neurology felbamate epilepsy electrical status epilepticus during sleep herpes drug resistance |
| title | Felbamate for pediatric epilepsy—should we keep on using it as the last resort? |
| title_full | Felbamate for pediatric epilepsy—should we keep on using it as the last resort? |
| title_fullStr | Felbamate for pediatric epilepsy—should we keep on using it as the last resort? |
| title_full_unstemmed | Felbamate for pediatric epilepsy—should we keep on using it as the last resort? |
| title_short | Felbamate for pediatric epilepsy—should we keep on using it as the last resort? |
| title_sort | felbamate for pediatric epilepsy should we keep on using it as the last resort |
| topic | felbamate epilepsy electrical status epilepticus during sleep herpes drug resistance |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.979725/full |
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