ABSTRACT
The more severe epilepsies usually begin in childhood; these often necessitate polytherapy, making drug interactions a frequent consideration. Although children manifest all of the toxicities that have been described in adults, drug-related cognitive impairment is a particular problem in school-age children. Benzodiazepines are used most frequently in pediatric epilepsy to treat status epilepticus and severe epilepsies, especially the encephalopathie epilepsies—West syndrome and Lennox-Gastaut syndrome. Although they are effective in absence seizures, the development of tolerance to the antiepileptic effect plus the high incidence of sedative and adverse behavioral effects render them generally unsatisfactory in benign epilepsies such as childhood absence epilepsy. Carbamazepine is widely used in children for the treatment of partial and generalized tonic-clonic seizures. Ethosuximide is used predominantly in children because absence seizures occurring as the sole seizure type is characteristic of childhood absence epilepsy. Phenobarbital remains an important drug in the treatment of status epilepticus in newborns, infants, and children.
