Abstracts

Rationale: Objective: Clobazam is indicated as adjunctive therapy for Lennox-Gastaut Syndrome (LGS), but there is limited data regarding seizure outcome for partial seizures. In this study, we present twelve consecutive patients that failed resective surgery for medically refractory epilepsy, who were started on clobazam adjunctive therapy. Methods: Methods: This is a retrospective chart review of twelve patients (8F/4M; mean age 33, range 21 to 55, years old) who were followed at the South Texas Comprehensive Epilepsy center in San Antonio (Table 1). They were started on clobazam adjunctive therapy 6 months to 15 years after failed resective surgery. Seizure data included average number of partial (including simple, complex or secondary generalized tonic-clonic) as well as myoclonic seizures per month before and after initiation of clobazam treatment with a median follow-up of 8 (range 3 to 24) months. Results: Key Findings: Eight (67%) of twelve patients had a >75% seizure reduction, 2 had at least 50% seizure reduction, while two patients had no change in seizure frequency. The adverse side effects included sedation in four, headache in one and weight gain in one patient, and dry mouth in one patient respectively. In one patient, sedation led to discontinuation of clobazam. The mean clobazam dose was 25 (range 10-60) mg/day. Conclusions: Conclusions: Clobazam proved to an effective, long-term treatment for medically refractory partial seizures in patients who had failed previous resective surgery. The effective mean dose was relatively low compared to treatment of LGS. None of the patients had evidence of multifocal or generalized epilepsy before or after resective surgery, and it is unclear to what extent the resection of epileptic cortex rendered them more responsive to clobazam. It is essential to increase the sample size and extend the follow-up duration to demonstrate clobazam's effectiveness, and to evaluate underlying mechanisms of this surprising response.