Abstracts

Clobazam is a benzodiazepine with excellent antiepileptic action; however, it is not considered as first line therapy in the treatment of epilepsy. The objective of this study was to evaluate the efficacy of clobazam as add-on therapy in adults with refractory temporal lobe epilepsy associated with hippocampal atrophy.
This was a retrospective study, conducted at the epilepsy clinic of our university hospital. We evaluated the patients that were exposed to clobazam as add-on therapy from a group of 100 consecutive patients with temporal lobe epilepsy and hippocampal atrophy. Clobazam was prescribed based on the concept of maximum tolerated dose.
Seventy-eight patients met the inclusion criteria (51 women), ages ranging from 16 to 76 years old (mean= 42.2). Dosage of clobazam ranged from 5 to 60 mg/day (mean = 22.6 mg/day). Clobazam was used from 1 month to 8 years (mean = 29 months). Sixteen (20.5%) patients were seizure free, 20 (25.5%) had more than 75% improvement in seizure control, eight (10%) had more than 50% and three (4%) had less than 50% improvement. Seizure frequency remained unchanged after addition of clobazam in 17 (22%) patients. In 14 (18%) there was no data available. The improvement in seizure control lasted for more than 1 year in 30 (68%) patients.
Clobazam has an excellent efficacy even for patients that would be considered as candidates for epilepsy surgery. That is, clobazam should be considered as first line add-on therapy in patients with refractory temporal lobe epilepsy and hippocampal atrophy.