Abstracts

Rationale: Pregabalin is a new antiepileptic drug (AED) used as adjunctive treatment for partial epilepsy. It acts at presynaptic calcium channels, modulating neurotransmitter release. Our objective is to report our experience with pregabalin in treating children with severe drug resistant epilepsy. Methods: Prospective, open label, add on trial of pregabalin in treating consecutive children with intractable epilepsy. Follow up by one pediatric neurologist was performed to document therapeutic response. Results: 19 children (63% males) aged 4-15 years (mean 9.7, SD 2.9) were included. Most children (74%) had daily seizures that failed multiple AEDs (mean 5, SD 1.5). The epilepsy was symptomatic in 58%, and 74% had associated cognitive deficits. The seizures were mixed in 9 (47%) and 4 (21%) had Lennox Gastaut syndrome. Pregabalin was maintained at 150-300 mg/day. On pregabalin, one (6%) child became completely seizure free and 7 (37%) had >50% seizure reduction. The percentage of children with daily seizure was reduced from 74% before pregabalin to 37% afterward (p <0.002). Side effects were noted in 6 (32%) children in the form of somnolence, weight gain, dizziness, and behavioral change. The drug had to be withdrawn in 5 (26%) children for of lack of efficacy and in 2 (11%) for worsening of myoclonic epilepsy. Conclusions: Pregabalin is a useful addition in the treatment of refractory childhood epilepsy. The drug should be used with caution in myoclonic epilepsy. Controlled studies are needed to establish the long term efficacy and tolerability in children.