Abstracts

Oxacarbazepine(OCBZ) approved as adjunctive therapy in the treatment of partial seizures in children ages 4-16. Unwanted provocation of status epilepticus(SE), was previously reported in 2 mentally retarded patients from Finland. We report 3 patients with static encephalopathy, mental retardation and OCBZ-induced SE. The purpose of this analysis is to identify the patients at risk for development of this serious complication while treated with OCBZ.
Retrospective chart review was performed on patients seen at Children[rsquo]s Hospital of Pittsburgh with childhood epilepsy treated with OCBZ. Data regarding demographics, diagnosis, treatment duration, medication doses, and EEG findings were collected and analyzed.
20 children with partial seizures with or without cognitive problems were treated with OCBZ. 4 experienced worsening of seizures when OCBZ was added(4 male; mean age, 11.25years; range 9-13; average age of seizures onset 3yrs, on average 3 other anticonvulsants used). 2 children had Lennox Gastaut syndrome(1-microcephaly, 1-Dandy-Walker syndrome), 2 [ndash] mild learning problem. Average OCBZ dose was 18.5mg/kg/day, 1 patient was rechallenged twice. 3 patients developed convulsive SE, 1 had significant increase in seizures after an average 0.75mo. Previous SE was documented in 1. Discontinuation of OCBZ and treatment with ativan and phenytoin resulted in clinical and electrographic resolution of SE.
Children with intellectual disability may be at the greater risk of developing SE while treated with OCBZ. Perhaps, OCBZ exacerbated primary generalized activity in those patients. More data is needed to evaluate this hypothesis. Of an additional interest: in 3 patients prior treatment with carbamazepine did not result in this complication.