We conducted a Japanese Expert Consensus (EC) study for the treatment of childhood
epilepsies following the method reported from the USA and EU (Wheless JW, et al., 2005, 2007), and compared the results to reveal differences in the choice of
antiepileptic drugs (AEDs). The subjects were 41 pediatric board-certified epileptologists who responded to the 23 questionnaires. A 9-point scale was used to grade each AED, in which 9 was the best whereas 1 was the worst for appropriateness of choice for each
epileptic syndrome.
Lamotrigine (LTG) is frequently used for
idiopathic generalized epilepsy except for
valproate sodium (VPA) in both the USA and EU, while VPA and
clonazepam were the main AEDs in Japan. For cryptogenic
complex partial epilepsy and benign
focal epilepsy,
carbamazepine was a first-line AED among the USA, EU, and Japan, although other first-line AEDs were
oxcarbamazepine (OCBZ), LTG, and
levetiracetam (LEV) in both the USA and EU, while it was
zonisamide in Japan. Regarding the treatment for
symptomatic generalized epilepsy,
West syndrome and
Lennox-Gastaut syndrome, VPA and
ACTH were first-line AEDs commonly used in the USA, EU, and Japan, while the other first-line AEDs were
topiramate (TPM) and LTG in the USA and EU, and CZP and
clobazam in Japan. This Japanese EC study demonstrated the difference in the selection of AEDs for
epileptic syndromes between the USA and EU, which use more newly-introduced AEDs including TPM, LTG, OCBZ and LEV as first-and second-line AEDs, and Japan.