Abstract
The new antiepileptic ones have potential advantages including different mechanisms of action, fewer interactions, better therapeutic range, fewer side effects, better pharmacokinetic and in the majority there is no need of serum levels. There is checked the use of the new antiepileptic medications in pediatrics emphatically in his use as monotherapy. Nowadays the use of the felbamate is reduced primarily to refractory cases of Lennox-Gastaut’s syndrome; his prominent side effects are gastrointestinal with anorexia and weight loss. Felbamate has proved his efficiency in refractory epilepsies. Gabapentin has usefulness for the treatment of partial crises, Rolandic benign epilepsy and other benign syndromes. Gabapentin can be in use in increases of 10 mg/kg/day up to a maximum of 80-100 mg/kg/day. The side effects include agitation, lethargy, sedation, gastric symptoms, anorexia, insomnia, ataxia, quake, dizziness and weight profit. Lamotrigin has been in use for multiple types of crisis and epileptic syndromes. It has been effective in partial, tonic crises, tonic-clonics and atonics. Also it is effective in patients with absences and other syndromes as Lennox-Gastaut and the infantile spasms. Topiramate has been used as wide spectrum drug in monokey and politherapy in partial, partial with generalization crises, generalized, infantile spasms and Lennox-Gastaut’s syndrome. Zonisamide has been in use as a medication of wide spectrum in partial and generalized crises and infantile spasms. Zonisamide seems to have special usefulness in juvenile myoclonic epilepsies where it can control three types of crisis: mioclonics, tonic-clonics and absences. Levetiracetam has been used traditionally for the treatment of partial and secondarily generalized seazures. Analyzing the existing information we conclud that there are studies that evaluate the efficiency and tolerance of new antiepileptic in monotherapy in children.
References
Kaufman DW, Kelly, JP, Anderson, T, Harmon, DC, Shapiro S. Evaluation of case reports of aplastic anemia among patients treated with felbamate. Epilepsia 1997; 38: 1265-9.
The Felbamate Study Group in Lennox-Gastaut Syndrome. Efficacy of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). N Engl J Med 1993; 328: 29-33.
Borowicz KK, Piskorska B, Kimber-Trojnar Z, et al. Is there any future for felbamate treatment? Pol J Pharmacol 2004; 56: 289-94.
Bourgeois, BF. Drug treatment of benign focal epilepsies of childhood. Epilepsia 2000;41: 1057-8.
Chadwick, DW, Anhut, H, Greiner, MJ, et al. 1998, A double-blind trial of gabapentin monotherapy for newly diagnosed partial seizures. International Gabapentin Monotherapy Study Group 945-77. Neurology 51: 1282-8.
Trudeau V, Myers S, LaMoreaux L, et al. Gabapentin in naive childhood absence epilepsy: results from two double-blind, placebo-controlled, multicenter studies. J Child Neurol 1996; 11: 470-5.
Barron TF, Hunt SL, Hoban TF, Price ML. Lamotrigine monotherapy in children. Pediatr Neurol 2000; 23: 160-3.
Buchanan N. The use of lamotrigine in juvenile myoclonic epilepsy. Seizure 1996;5: 149-51.
Valencia I, Kothare SV, Khurana DS, et al. Efficacy and tolerability of Lamictal as monotherapy in pediatric epilepsy. Epilepsia 2004 ; 45: 326.
Sachdeo RC, Glauser TA, Ritter F, et al. A double-blind, randomized trial of topiramate in Lennox- Gastaut syndrome. Topiramate YL Study Group. Neurology 1999; 52: 1882-7.
Gilliam FG, Veloso F, Bomhof MA, et al. A dose-comparison trial of topiramate as monotherapy in recently diagnosed partial epilepsy. Neurology 2003; 60: 196-202.
Cross JH. Topiramate monotherapy for childhood absence seizures: an open label pilot study. Seizure 2002; 11: 406-10.
Glauser TA, Clark PO, McGee K. Long-term response to topiramate in patients with West syndrome. Epilepsia 2000: 41 Suppl 1: S91-4.
Glauser TA, Clark PO, Strawsburg R. A pilot study of topiramate in the treatment of infantile spasms. Epilepsia 1998; 39: 1324-8.
Valencia I, Fons C, Kothare SV, et al. Efficacy and tolerability of topiramate in children younger than 2 years old. J Child Neurol 20: 667-9.
Kothare, SV, Khurana, DS, Valencia, I, et al. 2004, Efficacy and tolerability of topiramate as monotherapy in epilepsy: a pediatric experience. Neurology 2005; 56: S116.
Salinsky MC, Storzbach D, Spencer DC, et al. Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology 2005; 64: 792-8.
Craig JE, Ong TJ, Louis DL, Wells JM. Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma. Am J Ophthalmol 2004; 137: 193-5.
de Borchgrave V, Lienard F, Willemart T, van Rijckevorsel K. Clinical and EEG findings in six patients with altered mental status receiving tiagabine therapy. Epilepsy Behav 2003; 4: 326-37.
Vinton A, Kornberg AJ, Cowley M, et al. Tiagabine-induced generalised non convulsive status epilepticus in patients with lesional focal epilepsy. J Clin Neurosci 2005; 12: 128-33.
Holden KR, Titus MO. The effect of tiagabine on spasticity in children with intractable epilepsy: a pilot study. Pediatr Neurol 1999; 21: 728-30.
Lotze TE, Wilfong AA. Zonisamide treatment for symptomatic infantile spasms. Neurology 2004; 62: 296-8.
Yanai S, Hanai T, Narazaki O. Treatment of infantile spasms with zonisamide. Brain Dev 1999; 21: 157-61.
Kim HL, Aldridge J, Rho JM. Clinical experience with zonisamide monotherapy and adjunctive therapy in children with epilepsy at a tertiary care referral center. J Child Neurol 2005; 20: 212-9.
Newmark ME, Dubinsky S. Zonisamide monotherapy in a multi-group clinic. Seizure 2004; 13: 223-5.
Iinuma K, Minami T, Cho K, Kajii N, Tachi
N. Long-term effects of zonisamide in the treatment of epilepsy in children with intellectual disability. J Intellect Disabil Res 1998; 42 Suppl 1: 68-73.
Kishi T, Nejihashi Y, Kajiyama M, Ueda
K. Successful zonisamide treatment for infants with hypsarrhythmia. Pediatr Neurol 2000; 23: 274-7.
Ohno M, Shimotsuji Y, Abe J, Shimada M, Tamiya H. Zonisamide treatment of early infantile epileptic encephalopathy. Pediatr Neurol 2000; 23: 341-4.
Suzuki Y. Zonisamide in West syndrome. Brain Dev 2001; 23: 658-61.
Suzuki Y, Imai K, Toribe Y, et al. Long-term response to zonisamide in patients with West syndrome. Neurology 2002; 58: 1556-9.
Traverse LD. Successful zonisamide treatment for infants with hypsarrhythmia. Pediatr Neurol 2001; 25: 422.
Yanagaki S, Oguni H, Yoshii K, et al. Zonisamide for West syndrome: a comparison of clinical responses among different titration rate. Brain Dev 2005;27: 286-90.
Kothare SV, Valencia I, Khurana DS, et al. Efficacy and tolerability of zonisamide in juvenile myoclonic epilepsy. Epileptic Disord 2004; 6: 267-70.
Mostofi N, Khurana DS, Reumann M, et al. Efficacy and tolerability of zonisamide monotherapy in a cohort of children with epilepsy. Epilepsia 2005;46: 199.
Ohtahara S, Yamatogi Y. Safety of zonisamide therapy: prospective follow-up survey. Seizure 2004: 13 Suppl 1: S50-5; discussion S56.
Lynch BA, Lambeng N, Nocka K, et al. The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci USA 2004;101: 9861-6.
Koukkari MW, Guarino EJ. Retrospective study of the use of levetiracetam in childhood seizure disorders. J Child Neurol 2004;19: 944-7.
Khurana DS, Kothare SV, Melvin JJ, Valencia I, Legido A. Efficacy and tolerability of Levetiracetam as monotherapy in children with epilepsy. Epilepsia 2005; 46: 197.
Beydoun A, Sachdeo RC, Rosenfeld WE, et al. Oxcarbazepine monotherapy for partial-onset seizures: a multicenter, double-blind, clinical trial. Neurology 2000; 54: 2245-51.
Herranz JL, Argumosa A, Salas-Puig J. [Oxcarbazepine in monotherapy in 324 patients with partial seizures (TRINOVA study)]. Rev Neurol 2004; 39: 601-6.
Guerreiro MM, Vigonius U, Pohlmann H, et al. A double-blind controlled clinical trial of oxcarbazepine versus phenytoin in children and adolescents with epilepsy. Epilepsy Res 1997; 27: 205-13.
Kothare SV, Mostofi N, Khurana DS, et al. Oxcarbazepine monotherapy for partial epilepsy in a pediatric population. Epilepsia 2005; 46: 197.
Borusiak P, Korn-Merker E, Holert N, Boenigk HE. Hyponatremia induced by oxcarbazepine in children. Epilepsy Res 1998; 30: 241-6.
Holtmann M, Krause M, Opp J, et al. Oxcarbazepine-induced hyponatremia and the regulation of serum sodium after replacing carbamazepine with oxcarbazepine in children. Neuropediatrics 2002; 33: 298-300.
Kurul S, Dirik E, Iscan A. Serum carnitine levels during oxcarbazepine and carbamazepine monotherapies in children with epilepsy. J Child Neurol 2003;18: 552-4.
Zelnik N, Fridkis I, Gruener N. Reduced carnitine and antiepileptic drugs: cause relationship or co-existence? Acta Pediatr 1995; 84: 93-5.
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