Success in treating childhood epilepsy

Epilepsy affects the brain

Doctors have had success in treating a form of childhood epilepsy with a drug called stiripentol.

The drug has proved to be effective in trials when used to treat children with severe myoclonic epilepsy in infancy (SMEI).

In children with SMEI, seizures appear during the first year of life and never come under complete control with conventional antiepileptic drugs.

All children develop mental retardation from the second year of life.

Stiripentol showed promise in treating SMEI in a previous trial when combined with two other drugs, clobazam and valproate.

To confirm these results, researchers from Hopital Saint Vincent de Paul in Paris carried out a new trial involving 41 children with SMEI.

The children were all given clobazam and valproate for one month.

Then half were also given stiripentol and half a placebo for a further period of two months.

The researchers found that during the third month of the trial the frequency of seizures was cut by at least half in 71% of the children who were given stiripentol.

Nine of these children suffered no seizures at all.

In comparison, the frequency of seizures was cut by half in just one (5%) child who was given a placebo.

Side effects

The 21 patients on stiripentol had moderate side-effects, including drowsiness and loss of appetite.

But the side effects disappeared when the dose of co-medication was decreased in 12 of the 21 cases.

Writing in The Lancet medical journal, the researchers stress that anti-epileptic drugs must be tested on children before it can be said for certain whether they will work, or are appropriate to administer.

Currently, many trials are only carried out on adults, and it assumed that the results apply to children.

They say: "The results obtained in adults cannot be extrapolated to children because some epilepsy syndromes do not exist in adults and tolerability can be different according to age."

The researchers also question the wisdom of testing drugs on all children with epilepsy without distinguishing between the differing forms of the condition.

There are different types of childhood epilepsies, caused by different factors, they say.

Consequently, it is likely that new drugs may have a beneficial effect on one type of epilepsy, and not another.