Revisiting the role on antiepileptic drugs in idiopathic childhood epilepsy- an observational outcomes study in Eastern India

Authors

  • Sabnam Ara Begum Assistant Professor, Department of Pharmacology, R G Kar Medical College & Hospital, Khudiram Bose Sarani, Kolkata, West Bengal, India
  • Swati Bhattacharyya Associate Professor, Department of Pharmacology, R G Kar Medical College & Hospital, Khudiram Bose Sarani, Kolkata, West Bengal, India
  • Rahul Ghosh Hazra Demonstrator, Department of Pharmacology, R G Kar Medical College & Hospital, Khudiram Bose Sarani, Kolkata, West Bengal, India
  • Arunava Biswas Associate Professor, Department of Pharmacology, Coochbehar Government Medical College & Hospital & MJN Hospital, PO & Dist Coochbehar, West Bengal, India
  • Debajyoti Saha Demonstrator, Department of Pharmacology, Calcutta National Medical College, 32 Gorachand Road, Beniapukur, Kolkata, West Bengal, India
  • Sukanta Sen Professor & Head, Department of Pharmacology, ICARE Institute of Medical Sciences and Research, Banbishnupur, Purba Medinipur, Haldia, West Bengal, India
  • Santanu Kumar Tripathi Ex-Professor & Head, Department of Clinical & Experimental Pharmacology, Calcutta School of Tropical Medicine, 108, Chittaranjan Avenue, Kolkata, West Bengal, India

Keywords:

Antiepileptic drugs, Idiopathic childhood epilepsy

Abstract

Introduction: Seizures constitute the most common neurological disorder in children and the majority of epilepsy has its onset in childhood. Epilepsy, particularly childhood epilepsy, remains a challenge to treat. Despite the increase in the number of antiepileptic drugs (AEDs), more than 25% of children with idiopathic childhood epilepsy continue to have seizures. In spite of continued emergence of newer drugs, the response to antiepileptic therapy is still unpredictable and unsatisfactory. The physicians and even the neurologists are in a dilemma and vary from one another in selecting the most appropriate drug in a particular type of epilepsy. Monotherapy is the usual dictum, but polytherapy is needed for patients with multiple seizure types or refractory disease. It is felt, therefore, necessary to know the prevalence of various types of childhood epilepsy and the prescribing pattern of antiepileptic drugs. Objectives: The study was conducted to evaluate the prescribing pattern of antiepileptic drugs in different types of idiopathic childhood epilepsy and to compare the efficacy and safety profile of commonly used AEDs. Methodology: A total of 100 Idiopathic epileptic patients of both sexes below 18 yrs of age who were prescribed AEDs were considered for analysis. Demographic profile, type of epilepsy, AEDs, number of epileptic events, biochemical, EEG and ADR (Adverse drug reaction) data were collected and analyzed. Results: A total of 100 subjects were analyzed, of whom 56% were male. The mean age at onset of epilepsy was 5.5 years. Incidence of Generalized Tonic-Clonic Seizure (GTCS) was 79%, Complex Partial Seizure 63%, Partial Seizure with Secondary Generalization 32%, Simple Partial Seizure 8%, Myoclonic 8%, Absence 7% and Atonic 5%. Valproate was the most commonly prescribed drug in GTCS, Atonic, Myoclonic and Absence seizure. Carbamazepine was commonly prescribed drug in Partial seizure. A total of 110 AEDs (i.e.1.1 AED per patient) were prescribed. The majority of subjects (90%) required monotherapy. Overall, only 6% patients received newer AED and majority of patients (94%) were on older AED therapy. Valproate achieved fastest seizure control in 95% of children within three months whereas Carbamazepine and Phenytoin required six months of therapy to achieve the same extent of seizure control. Major adverse events that resulted in cessation of antiepileptic medication were reported in 3 (3%) subjects. Two (2%) patients treated with carbamazepine had major adverse events that include rash (2patient).One (1%) patients treated with valproate develop weight gain (1patient). One (1%) patient treated with phenytoin had gum hyperplasia. One (1%) patients treated with phenytoin had major adverse events that include ataxia and nystagmus. Conclusion: Idiopathic childhood epilepsy was more common in male children of mean age of 5.5year. GTCS was the commonest type of epilepsy. The majority of epileptic children received monotherapy and older AEDs. Valproate was the commonly prescribed drug in all type of epilepsy other than Partial seizure. It was the most effective and safe drug compared to other AEDs.

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Published

2021-03-15

How to Cite

Begum, S. A., Bhattacharyya, S., Hazra, R. G., Biswas, A., Saha, D., Sen, S., & Tripathi, S. K. (2021). Revisiting the role on antiepileptic drugs in idiopathic childhood epilepsy- an observational outcomes study in Eastern India. International Journal of Health and Clinical Research, 4(5), 272–275. Retrieved from https://www.ijhcr.com/index.php/ijhcr/article/view/1132

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