Abstracts

Rationale: Background Epilepsy affects approximately one percent of the population, with up to 30% of patients continuing to have seizures despite antiepileptic drug treatment. Objectives To assess the efficacy and tolerability of Clobazam when used as an add-on therapy for patients with refractory partial onset or generalized onset seizures. Methods: We searched the following for randomised controlled trials using the search terms "Epilepsy", "Seizure","Clobazam", on the 22nd March 2007: (a)Cochrane Epilepsy Group Trials Register; (b)Cochrane Central Register of Controlled Trials (CENTRAL); (c)MEDLINE; (d)EMBASE. Results: Four crossover studies of significant methodological heterogeneity were identified, representing 196 participants. Two of which report >50% seizure reduction in 57.7% and 52.4% of the group, although only the latter is in comparison to pre-trial baseline. Two report statistically significant reductions in mean seizure frequency for partial onset seizures (p< 0.02). Conclusions: Clobazam as an add-on therapy may reduce seizure frequency in refractory epilepsy and this may be greatest in partial onset seizures. However, it is not clear which patients will benefit and how long benefits will be sustained. A large scale, multi-centre RCT, incorporating subgroups of seizure types, with genetic profiling is required to provide more substantial data to support the more specific use of clobazam.