Authors :
Presenting Author: lokesh lingappa, MD, DM, MRCPCH – Rainbow Children's Hospital, Hyderabad
Prithuja podyal, MBBS, MD – Pediatric Neurology Fellow, Pediatric Neurology, Rainbow Children's Hospital
Rationale:
Approximately 70% of childhood absence epilepsy are well controlled with valproate and ethosuximide. We studied the safety and long term efficacy of amantadine in children with refractory absence epilepsy.
Methods:
Retrospective data was analyzed after retrieving from electronic medical records in 17 children with refractory absence epilepsy attending the outpatient department of Pediatric Neurology at Rainbow Children Hospital. Study period was three years from June 2019 to November 2022. Children resistant to multiple antiseizure medication were started on amantidine. The efficacy and any adverse events were documented.
Results:
A total of 172 children with absence epilepsy were on follow up during study period. All children had generalized or absence seizure, multiple episodes per day despite multidrug therapy with ethosuximide, valproate, levetiracetam, lamotrigine, lacosamide and zonisamide. A majority of the cases were male (58.8%). All cases (100%) had a decrease in seizure episodes within three months of starting Amantadine. Within one month of Amantadine, seven (41%) had seizure control, five (29.41%) had seizure control within three months, and the remaining five (29.41%) had decrease in seizure activity in next three to six months. Mean duration of follow up was from six months to three years. Eight of 17 (47.05%) children were seizure free on three years follow up and the remaining had good seizure control with decreased frequency of seizures. Good seizure control was seen with combination of Amantadine and valproate in 11 cases (64.70%), only Amantidine in five cases (29.41%) and one case (5.89%) had good seizure control with combination of Amantadine and Ethosuximide. One child (5.89%) developed transient headache after starting Amantadine.
Conclusions:
Amantadine can be a choice of drug for children with absence epilepsy refractory to valproate and ethosuximide without major adverse reaction.
Funding: None