Single and in combination antiepileptic drug therapy in children with epilepsy: how to use it

Claudia Francesca Oliva; Gloria Gangi; Silvia Marino; Lidia Marino; Giulia Messina; Sarah Sciuto; Giovanni Cacciaguerra; Mattia Comella; Raffaele Falsaperla; Piero Pavone; Claudia Francesca Oliva; Gloria Gangi; Silvia Marino; Lidia Marino; Giulia Messina; Sarah Sciuto; Giovanni Cacciaguerra; Mattia Comella; Raffaele Falsaperla; Piero Pavone

doi:10.3934/medsci.2021013

AIMS Medical Science

2021, Volume 8, Issue 2: 138-146. doi: 10.3934/medsci.2021013

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Single and in combination antiepileptic drug therapy in children with epilepsy: how to use it

1.
Department of Clinical and Experimental Medicine, University of Catania Postgraduate Training Program in Pediatrics, Catania, Italy
2.
Pediatric and Pediatric Emergency Department, University Hospital “Policlinico-Vittorio Emanuele”, Catania, Italy
3.
Pediatric Clinic, Department of Clinical and Experimental Medicine, University Hospital “Policlinico-Vittorio Emanuele”, Catania, Italy

Received: 12 February 2021 Accepted: 21 April 2021 Published: 29 April 2021

Treatment of childhood seizures is a pressing challenge within neuropediatrics because of its severe impact to the children and families affected by these debilitating disorders. It is of upmost importance to make an early diagnosis, to start a promptly treatment, to use therapy and dosage of the drug appropriately, based on the specific epileptic type and epileptic syndrome. Single therapy with appropriate dosage is the main approach to treatment. When the drug is the cause of an idiosyncratic reaction it is advisable to replace the suboptimal seizure response with another antiepileptic drug, combined therapy with two antiepileptic drugs is also a viable option. In childhood, polytherapy using more than two antiepileptic drugs remains controversial because the harm of interaction with deleterious drugs could potentially replace the damage caused by the seizures themselves. The use of three or more antiepileptic drugs should be limited to epileptic seizures that are particularly resistant to drugs and when non-drug antiepileptic therapies have failed. An approach to the difficult topic of epileptic treatment in childhood is reported. Key point: mono vs polytherapy in epileptic children; single and alternative therapy in epileptic children; use or three or more AEDs in children.
- epileptic seizures,
- antiepileptic drugs,
- children,
- side-effect
Citation: Claudia Francesca Oliva, Gloria Gangi, Silvia Marino, Lidia Marino, Giulia Messina, Sarah Sciuto, Giovanni Cacciaguerra, Mattia Comella, Raffaele Falsaperla, Piero Pavone. Single and in combination antiepileptic drug therapy in children with epilepsy: how to use it[J]. AIMS Medical Science, 2021, 8(2): 138-146. doi: 10.3934/medsci.2021013

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Abstract

Treatment of childhood seizures is a pressing challenge within neuropediatrics because of its severe impact to the children and families affected by these debilitating disorders. It is of upmost importance to make an early diagnosis, to start a promptly treatment, to use therapy and dosage of the drug appropriately, based on the specific epileptic type and epileptic syndrome. Single therapy with appropriate dosage is the main approach to treatment. When the drug is the cause of an idiosyncratic reaction it is advisable to replace the suboptimal seizure response with another antiepileptic drug, combined therapy with two antiepileptic drugs is also a viable option. In childhood, polytherapy using more than two antiepileptic drugs remains controversial because the harm of interaction with deleterious drugs could potentially replace the damage caused by the seizures themselves. The use of three or more antiepileptic drugs should be limited to epileptic seizures that are particularly resistant to drugs and when non-drug antiepileptic therapies have failed. An approach to the difficult topic of epileptic treatment in childhood is reported. Key point: mono vs polytherapy in epileptic children; single and alternative therapy in epileptic children; use or three or more AEDs in children.

Acknowledgments

The authors would like to thank Prof Lorenzo Pavone (Catania) for clinical advice and related suggestions. They would also like to thank AME Editor American manuscript Editors for editing the manuscript.

Conflict of interest

All the authors declare that there are not biomedical financial interests or potential conflicts of interest in writing this manuscript.

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