Nocturnal
frontal-lobe epilepsy is characterized by paroxysmal arousals,
motor seizures with dystonic or hyperkinetic features, and episodic nocturnal wanderings.
Carbamazepine is effective for seizure control in some of these patients, but
seizures may be refractory to multiple
antiepileptic drugs. We report on eight children between ages 4-16 years with nocturnal
frontal-lobe epilepsy who had a dramatic response to
oxcarbazepine at standard recommended doses, some of whom were refractory to previous
antiepileptic medications. Brain magnetic resonance imaging, routine electroencephalogram, and prolonged, continuous video-electroencephalogram telemetry were performed in all children. Nocturnal
frontal-lobe epilepsy was diagnosed by demonstrating ictal electroencephalogram changes originating from the frontal lobes. The children were followed for response of
seizures to
oxcarbazepine, side effects, and routine blood tests, including serum 10-monohydroxide derivative levels. The mean
oxcarbazepine dose was 30.4 mg/kg/day +/- 11.7 (mean +/- SD); the mean 10-monohydroxide level was 23.1 microg/mL +/- 8.6 (mean +/- SD).
Seizures improved within 4 days of
oxcarbazepine initiation in six children, whereas two children required higher doses. Their follow-up has ranged from 12 to 24 months, without seizure recurrence or serious side effects. Our patients demonstrate the efficacy of
oxcarbazepine for nocturnal hyperkinetic
seizures in children with nocturnal
frontal-lobe epilepsy.