Higher evening antiepileptic drug dose for nocturnal and early-morning seizures

Higher evening antiepileptic drug dose for nocturnal and early-morning seizures

Author Guilhoto, L. M. F. F. Autor UNIFESP Google Scholar
Loddenkemper, T. Google Scholar
Vendrame, M. Google Scholar
Bergin, A. Google Scholar
Bourgeois, B. F. Google Scholar
Kothare, S. V. Google Scholar
Institution Harvard Univ
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract We describe 17 children with nocturnal or early-morning seizures who were switched to a proportionally higher evening dose of antiepileptic drugs and were retrospectively reviewed for seizure outcome and side effects. of 10 children with unknown etiology, clinical presentation was consistent with nocturnal frontal lobe epilepsy (NFLE) in 5 and benign epilepsy with centrotemporal spikes (BECTS) in 3. After a mean follow-up of 5.3 months, 15 patients were classified as responders: 11 of these became seizure free (5 NFLE, 1 BECTS, 5 with structural lesions) and 4 (2 BECTS, 2 with structural lesions) experienced 75-90% reductions in seizures. Among two nonresponders, seizures in one had failed to resolve with epilepsy surgery. Nine subjects (53%) received monotherapy after dose modification, and none presented with worsening of seizures. Two complained of transient side effects (fatigue/somnolence). Differential dosing led to seizure freedom in 64.7% (11/17) of patients, and 88.2% (15/17) experienced >= 50% reductions in seizures. (C) 2010 Elsevier Inc. All rights reserved.
Keywords Antiepileptic drugs
Differential dosing
Nocturnal epileptic seizures
Circadian patterns
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Milken Family Foundation
American Epilepsy Society
Children's Hospital Boston
Harvard Medical School
Eisai Inc.
Grant number CAPES: 4225-09-0
Date 2011-02-01
Published in Epilepsy & Behavior. San Diego: Academic Press Inc Elsevier Science, v. 20, n. 2, p. 334-337, 2011.
ISSN 1525-5050 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 334-337
Origin http://dx.doi.org/10.1016/j.yebeh.2010.11.017
Access rights Closed access
Type Article
Web of Science ID WOS:000287833700029
URI http://repositorio.unifesp.br/handle/11600/33423

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