Contents

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Principles of Treatment of Epilepsy in Children and Adolescents 

Principles of Treatment of Epilepsy in Children and Adolescents
Chapter:
Principles of Treatment of Epilepsy in Children and Adolescents
Author(s):

Renzo Guerrini

DOI:
10.1093/med/9780199659043.003.0016
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 26 June 2022

Advances in clinical pharmacology, a better understanding of the molecular mechanisms involved in epileptogenesis, and a more precise diagnosis of the specific aetiologies and of epilepsy syndromes, have allowed more rational treatment choices. Knowledge of the main mechanisms of action and spectrum of efficacy of AEDs, and correct syndrome diagnosis are essential for rationale treatment. However, efficacy and safety data emerging from AED trials in children is difficult to interpret. In most trials, different epilepsy syndromes and etiologies are lumped together and the studies were not designed in general to detect worsening of seizures or specific reactions in different syndromes. Furthermore, finding that two or more drugs are equivalent when compared to one another on ‘newly diagnosed’ cases, does not rule out the possibility that all drugs are relatively ineffective and that spontaneous remissions or improvements significantly influence the results. Information on drug safety in children is scanty as AEDs are marketed for children only if they appear promising in adults, with considerable delay. Several treatment related issues are still widely debated because available evidence is incomplete or contradictory. These include when to start treatment, setting the targets for treatment, the cognitive and behavioural effects of antiepileptic drugs in children, syndrome specificity of drug response. Some of children who are refractory to antiepleptic drugs may benefit from surgical treatment and the benefits of early intervention have been emphasized. However, the average delay from seizure onset to surgery is too long.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.