%0 Journal Article
%T Current role of rufinamide in the treatment of childhood epilepsy: literature review and treatment guidelines.
%A Coppola G
%A Besag F
%A Cusmai R
%A Dulac O
%A Kluger G
%A Moavero R
%A Nabbout R
%A Nikanorova M
%A Pisani F
%A Verrotti A
%A von Stülpnagel C
%A Curatolo P
%J Eur J Paediatr Neurol
%V 18
%N 6
%D Nov 2014
%M 24929673
%F 3.692
%R 10.1016/j.ejpn.2014.05.008
%X OBJECTIVE: The literature on the efficacy and safety of rufinamide in childhood-onset epilepsy syndromes currently includes approximately 600 paediatric patients. This paper summarizes the views of a panel of experienced European epileptologists with regard to the current role of rufinamide in the treatment of childhood epilepsies.
RESULTS: Rufinamide is effective in decreasing the seizure frequency in the Lennox-Gastaut syndrome (LGS), especially tonic and atonic seizures. It might consequently be preferred to other drugs as a second-line treatment for LGS when drop-attacks are frequent. The mean responder rate in the published studies is 38% with seizure freedom achieved in 2.4% of patients. Rufinamide has shown some efficacy in epileptic encephalopathies other than LGS. It can be also effective as adjunctive therapy in children and adolescents with drug-resistant partial seizures. The available data suggest that rufinamide has an acceptable risk/benefit ratio with quite a low risk of aggravating seizures. Common adverse effects (somnolence, nausea and vomiting) are usually mild and self-limiting; they are more frequently observed during titration than in the maintenance phase, suggesting that low escalation rates might be associated with fewer adverse effects. Rufinamide appears to have a favourable cognitive profile compared with other antiepileptic drugs.
CONCLUSIONS: Rufinamide is only approved for adjunctive treatment of seizures associated with LGS in children 4 years of age and older. There are very few data on rufinamide treatment at the onset of LGS or early in the course of the disorder; whether early treatment will improve outcome has yet to be determined.