[Show abstract][Hide abstract] ABSTRACT: About 10% of seizures in children with epilepsy are typical absence seizures. Absence seizures have a significant impact on quality of life. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for typical absence seizures in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2007 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: clonazepam, ethosuximide, gabapentin, lamotrigine, and valproate.
[Show abstract][Hide abstract] ABSTRACT: This review discusses current pharmacological treatment of childhood absence epilepsy (CAE). The key to successful treatment is the correct diagnosis of the epileptic syndrome, hence the initial part of the paper discusses the definition, diagnostic criteria and epidemiology. This is followed by a detailed analysis of pharmacological agents used in the treatment of CAE. The characteristics of old and new anticonvulsants used in the treatment of CAE are also reviewed. For each of the drugs, the mechanism of action, usual dose, common side effects and recommendations for treatment are also discussed. A separate section focuses on instances when anticonvulsants may exacerbate seizures. Particular emphasis is given to the evidence currently available, on which clinical practice needs to be based.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the role of ethosuximide, sodium valproate and lamotrigine in children and adolescents with typical absence seizures (AS).
A systematic review of randomized controlled trials that included children or adolescents with typical absence seizures who received treatment with ethosuximide, sodium valproate or lamotrigine.
Four RCTs fulfilled the inclusion criteria. Due to the heterogeneity of the studies the results could not be pooled in a meta-analysis.
We found no reliable evidence to inform clinical practice. The design of further trials should be pragmatic and compare one drug with another.
[Show abstract][Hide abstract] ABSTRACT: Not enough evidence to show which drugs are best for treating seizures in children and adolescents with absence epilepsy Epilepsy is a disorder where seizures are caused by abnormal electrical discharges from the brain. Absence epilepsy involves seizures that cause a sudden loss of awareness. It often starts in childhood or adolescence. Three antiepileptic drugs are often used for absence epilepsy: valproate; ethosuximide and lamotrigine. Valproate can lead to weight gain, and may cause fetal abnormalities. The review found some evidence that individuals taking lamotrigine are more likely to be seizure free than those using placebos. No difference in effectiveness has been found between valproate and ethosuximide, but more research is needed.