OXCARBAZEPINE INDUCED HYPONATREMIA IN CHILDREN 0-10-MONTHS OF AGE
Abstract number :
2.220
Submission category :
Year :
2002
Submission ID :
1627
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Willie T. Anderson III, Frank J. Ritter, Michael D. Frost, John R. Gates. Minnesota Epilepsy Group, PA[reg], of United Hospital and Children[ssquote]s Hospitals and Clinics, St. Paul, MN; Clinical Assistant Professor, Department of Neurology, University o
RATIONALE: Oxcarbazepine (OXC) use in a clinical setting has been noted to contribute to development of hyponatremia in a manner similar to carbamazepine (CBZ). Children with severe developmental disabililties are more susceptible to hyponatremia due to OXC than developmentally normal children. The objective of this study was to define the actual clinical incidence of hyponatremia in children taking OXC.
METHODS: A total of 96 children (47 girls/49 boys, mean age 8.5 years, range 6-months to 18.6-years, average age seizure onset 3.1-years) were identified as being treated with OXC. Fifty five patients were identified from Minnesota Epilepsy Group[ssquote]s pathology database. Forty-one children were identified from the authors[ssquote] database at Riley Hospital for Children.
RESULTS: 77/96 (80.2%) patients[ssquote] post- treatment serum sodium levels were available. Fifty-nine of these also had OXC levels. Two of the patients had symptomatic hyponatremia (Na [lt]125). Both of these patients were G-tube fed all nutrition and medication. One patient was also on topamax; the other patient was on a weaning dose of phenobarbital. Five patients had asymptomatic hyponatremia (Na [lt]135). Average dose of OXC was 34.8 mg/kg/d with an average level of 24.37 mcg/ml. The patients were on an average of 2.1 antiepileptic medications. 20/96 (20.8%) patients were on OXC monotherapy. 7/96 (7.3%) patients had a vagal nerve stimulator. 66/96 (68.8%) patients were developmentally delayed (documented or clinical judgment IQ [lt]70). No correlation between development, dose, age, or number of concurrent antiepileptic medications and asymptomatic hyponatremia was found. 20/96 (20.8%) patients did not have follow-up sodium levels. None of these patients had clinical indication to obtain sodium levels.
CONCLUSIONS: Sodium measurement is not indicated for children with refractory epiilepsy taking OXC unless the patient is on G-tube feedings where normal homeostatic behaviors are not possible.
(Disclosure: Consulting - Yes., Honoraria - Yes.)