Sengottuvel Viswanathan
Young Research Forum: J Neurol Neurophysiol
Background:Epilepsy is achronic neurological morbidity in children. The treatment includes mainly antiepileptic drugs (AEDs). AEDs at times may fail to give complete seizure free interval and also cause adverse drug reactions (ADRs). Our study focused on the prescribing pattern of AEDs for various seizures, treatment outcomes and associated ADRs in children. Objectives: To study the prescribing pattern of AEDs in pediatric outpatient department and to record the seizure control and ADRs. Materials and Methods: Patient characteristics such as age, sex, body weight, diagnosis and comorbid illness were noted. Prescribing pattern of AEDs was assessed according to WHO indicators for drug utilization study. All 200 patients were followed up at 3 months for seizure control and ADRs. Seizure control was recorded, that is, good control if the child was seizure free since prior visit, fair if one seizure and poor for more than one seizure since last visit. ADRs were recorded and documented in a suitably designed form. Results: 200 children-59% boys and 41% girls were enrolled. Among them 61.5% had generalized seizures, 30% complex partial, 5% simple partial, 3% myoclonic and 0.5% absence seizures. The major etiology seen was neurocysticercosis among 30% of children. Regarding treatment with AEDs 87.5% received monotherapy and 12.5% combination therapy. Among monotherapy, 63.5% were prescribed valproate, 20.5% carbamazepine, 2.5% phenytoin. In combination therapy valproate with clobazam (8.5%) and valproate with levetiracetam (1%) were prescribed. In generalized epilepsy 89.5% and 50% of children showed good control with monotherapy and combination therapy respectively. For partial epilepsy 98.2% had good control with monotherapy and 66.7% with combination therapy. ADRs like irritability, sedation, poor school performance were seen higher with combination therapy. Conclusion: The results showed that monotherapy is more effective and safe as compared to combination therapy to treat generalized and partial epilepsy in pediatric population. Also it was found out that valproate was the most commonly prescribed drug for generalized seizures and carbamazepine for partial epilepsy in both monotherapy and combination therapy.
Sengottuvel Viswanathan completed M.B.B.S from Government medical college Coimbatore and currently a final year MD post graduate student from University College of Medical Sciences Delhi University,India. As a young researcher fascinated towards the challenges in diagnosing and managing various neurlogical disorders. Also involved in infectious disease projects.
