Epilepsy is defined as a condition of repeated episodes of convulsions. There are different types of epilepsy in children, from general convulsions, in which the whole body shakes, to partial or focal convulsions, in which only a specific part of the body convulses. Pharmacological treatment depends on the type of epilepsy, and children often undergo different combinations of medicines and doses to control their seizures. Most seizure medicines require close monitoring in children to prevent side effects or adverse events. The FDA has warned that all antiepileptic drugs have the potential to produce suicidal ideation in patients, including children.
Benzodiazepines
Benzodiazepines are drugs to treat status epilepticus, an episode of prolonged, uninterrupted seizure activity, in children. Some of these medicines include diazepam (Valium) and lorazepam (Ativan). Benzodiazepines work by depressing brain activity, modulating a protein called GABA, which inhibits transmission of signals between the brain's neurons, which are hyperactive during a seizure. Benzodiazepines have a long history of safety in the pediatric population.
Phenobarbital
This is one of the safest drugs for treating epilepsy in children and has long history in the management of the disorder. Phenobarbital also depresses brain activity by enhancing the activity of GABA, the inhibitory neuronal protein. Phenobarbital is used in the treatment of status epilepticus and also as a primary anti-seizure medicine, especially in neonates and infants.
Carbamezapine
Carbamezapine (Tegretol), is a useful anticonvulsant in the treatment of partial seizures and mixed partial-general convulsions. It causes less sedation than other anti-seizure medicines. It acts by decreasing transmission of signals between neurons, by decreasing the influx of sodium across the neuron's membrane. Sodium is an important element in the transmission of signals in the brain. It has a well-established safety profile in children, but levels need to be monitored to reduce the incidence of adverse effects, such as liver damage and decrease in platelets and white blood ells (the cells that fight infections in the body).
References
- Primary Care Pediatrics, Carol Green-Hernandez, Joanne K. Singleton, Daniel Z. Aronzon, 2001
- Current Pediatric Diagnosis and Treatment William W. Hay, Jr., et al, 2003
