Felbamate for infantile spasms syndrome resistant to first-line treatments.

Abstract

AIM:

To analyse the effects of felbamate in refractory infantile spasms/West syndrome.

METHOD:

We conducted a 10-year retrospective study of infants (including all infants younger than 18mo) treated with felbamate for electroencephalography-recorded epileptic spasms persisting after first-line treatment.

RESULTS:

In total, 29 infants (17 males, 12 females) were included in the study. Felbamate was initiated at a mean age of 13.8 months (range 4.5-66mo) after sequential administration or combination of vigabatrin and oral steroids; a ketogenic diet was implemented in 23 infants. Eight infants became spasm-free at a mean dose of 34.6mg/kg/day felbamate (range 26-45mg/kg/day). Mean duration of felbamate use was 19 months (range 1-67mo) for the 19 infants whose treatment was terminated. No severe side effects were observed. Reversible neutropenia led to withdrawal of felbamate in six patients. One spasm-free patient demonstrated recurrence when felbamate was withdrawn.

INTERPRETATION:

N-methyl-d-aspartate receptors with felbamate controlled epileptic spasms in eight infants resistant to first-line treatment should be targeted.

• Authors: Blandine Dozières-Puyravel, Hala Nasser, Vanina Bellavoine, Adina Ilea, Catherine Delanoe, Stéphane Auvin
• Journal: Developmental medicine and child neurology (Dev Med Child Neurol) Vol. 62 Issue 5 Pg. 581-586 (05 2020) ISSN: 1469-8749 [Electronic] England
• PMID: 31850517 (Publication Type: Journal Article)
• Copyright: © 2019 Mac Keith Press.

Chemical References

• Anticonvulsants
• Felbamate

Topics

• Anticonvulsants (therapeutic use)
• Drug Resistance
• Electroencephalography
• Felbamate (therapeutic use)
• Female
• Humans
• Infant
• Male
• Retrospective Studies
• Spasms, Infantile (drug therapy, physiopathology)
• Treatment Outcome