The Efficacy of Add-on Therapy of Clobazam in Epileptic Children

Choi, Bong Seok; Nam, Sang Ook

Abstract

PURPOSE: Clobazam is a 1,5-benzodiazepine which has a unique structure different from other benzodiazepines and shows different spectrum in treatment of epilepsy. We evaluated the efficacy of clobazam as an add-on therapy in childhood epilepsy.
METHODS
We reviewed the medical records of 44 patients, who had been on medication with clobazam. The frequency of seizure attacks, occurrence of adverse effects and resistance of the drug were monitored. We defined the patients who showed seizure reduction over 90% as a success outcome group and the others as a non-success outcome group. We analysed the factors that predict favorable response.
RESULTS
Thirteen patients(29.5%) were seizure free, nine patients(20.5%) had more than 90% improvement, fourteen patients(31.8%) had between 50-90% improvement, and eignt patients(18.2%) had less than 50% improvement in seizure control. Age at seizure onset was higher in success outcome group(P=0.035). MRI abnormalities, EEG abnormalities, seizure type, the number of drugs medicated before the use of clobazam, seizure frequencies, seizure duration before clobazam medication, and age at the start of clobazam had no statistical differences. Seven out of 44 patients(15.9%) showed resistance to clobazam. Adverse effects included increase sleep time(8.1%) and bronchial secretion (4.5%).
CONCLUSION
Add-on therapy of clobazam is effective in the management of epileptic children especially in older epileptic children and adverse effects are trivial.