Abstracts

RATIONALE: Antiepileptic drugs (AEDs) may aggravate partial epilepsy, worsening EEG discharges and/or clinical seizures. Carbamazepine (CBZ) and oxcarbamazepine (OXC) have been more commonly implicated with increased number of seizures and appearance of new seizure types and EEG discharges. METHODS: We report on three children with epilepsy who had worsening of the epilepsy and appearance of new EEG changes and seizure types (one case) after the indroduction of CBZ or OXC. RESULTS: Clinical history: Patient 1: 8 year-old girl with complex partial seizures (CPC). After the introduction of CBZ, CPC were controlled and the child presented brief and frequent absences, with an ictal pattern of generalized 2.5-3.0 Hz spike-wave and generalized spikes and normal background activity. Decreased performance in school was noted. PHT was substituted for CBZ and absences stopped; the EEG showed right temporal sharp waves. Cognitive complaints improved. Patient 2: 9 year-old girl with congenital right hemiparesis, partial motor seizures and left posterior quadrant epilptiform discharges. After introduction of CBZ, generalized 3 Hz spike-wave discharges appeared, without concomitant worsening of seizures. After CBZ was stopped, these discharges disappeared and the EEG showed posterior quadrant sharp waves. Patient 3: 9 year-old with benign rolandic epilepsy with occasional centrotemporal discharges, who presented worsening of EEG discharges with introduction of OXC. CONCLUSIONS: CBZ and OXC may lead to new seizure types and discharges in childhood epilepsy; these changes are reversible with discontinuation of the AED.