Very little data are available on the usefulness of
oxcarbazepine in young children with
epilepsy. From January 1991 through October 1994, we treated 53 children under age 7 years with
oxcarbazepine. The mean follow-up with
oxcarbazepine treatment was 13 months. Etiology was symptomatic in 39, cryptogenic in 12, and idiopathic in 2 children. Forty-three children had previously been intractable to one or more
antiepileptic drugs (including
carbamazepine in 30 patients) and two had
carbamazepine hypersensitivity. The age at onset of
oxcarbazepine therapy ranged from 0.6 to 6.9 years (mean, 3.9 yr). The mean maximum
oxcarbazepine dose was 50 mg/kg/day (range, 21-86 mg/kg/day). Of the children with
localization-related epilepsy, 12 of 44 (27%) became seizure free and an additional 16 of 44 (36%) had an at least 50% reduction of
seizures. Five of nine children with
generalized epilepsy also had some benefit but none became seizure free. In the 33 children with at least 50% seizure reduction, the mean effective dose and trough serum level of the active metabolite monohydroxycarbazepine were 47 mg/kg/day (range, 21-75 mg/kg/day) and 91 micromol/L (range, 42-130 micromol/L), respectively. Efficacy was transient in 4 children; side effects were observed in 17 children (32%); in 9 (17%) of whom, they led to
dose reduction or discontinuation.
Oxcarbazepine appears to be an effective and well-tolerated
drug for localization-related early childhood
epilepsy. Young children need a higher dose per
body weight than adults.