Clobazam in Refractory Childhood Epilepsy

Objective. To evaluate the efficacy of clobazam in childhood refractory epilepsy and to characterize the adverse drug reaction profile in the Indian population. Methods. A cohort of 88 children with 'refractory' epilepsy was started on clobazam as add-on therapy. Diagnosis was established and seizure type recorded. Therapeutic response was recorded as 'complete', 'good', and 'no response'. Observed side effects were classified as 'mild', 'moderate' and 'severe'. Results. Most children were on at least two antiepileptics. Seizures most identified were either partial (36.3%) or generalized tonic-clonic (15.9%). The dose ranged from 0.3-2 mg/kg/day (average 1+0.2 mg/kg/day). Clobazam was effective against all seizure types with complete seizure control seen in 60.2% patients. Tolerance was seen in 5 (5.6%) patients. Side effects were seen in 23 (26%) patients and were 'mild' in 20 (86.9%) of them. Clobazam was stopped in three patients who developed ataxia, which resolved on stopping the drug. Conclusion. Clobazam was observed to be an effective broad-spectrum antiepileptic with 'mild' side effects in Indian children. [Indian J Pediatr 2010; 77 (3) : 263-266] E-mail: drrachnaseth@yahoo.co.in