Treatment Options for Children With Epilepsy

Disclaimer: I am not a medical professional and you should always discuss any health concerns with your doctor. This blog draws on my personal experience and research and the information contained should not substitute advice or directions from your doctor.

I was talking to a new friend yesterday, and she was telling me how much trouble she's having with her daughter's medications. Since writing and research is my god given skill, this is for her to take to her daughter's next neurologist appointment.

Depakote: Depakote is approved for children, but has a much higher instance of liver failure in children under the age of 3 than in adults and older children. Liver damage will usually occur withing the first six months of treatment and the first signs are vomiting, yellowing of the skin or eyes, loss of appetite, sluggishness, and possible loss of seizure control.

In girls over ten, higher than normal testosterone levels are sometimes observed.

Common side effects include:

mild drowsiness or weakness;

diarrhea, constipation, upset stomach;

changes in your menstrual periods;

enlarged breasts, weight changes;

tremor (shaking);

hair loss;

vision changes; or

unusual or unpleasant taste in your mouth

Serious side effects include:

unexplained weakness with vomiting and confusion or fainting;

easy bruising or bleeding, blood in your urine;

fever, chills, body aches, swollen glands, flu symptoms;

urinating less than usual;

extreme drowsiness, lack of coordination, hallucinations;

double vision or back-and-forth movements of the eyes; or

To reduce side effects, usually a doctor will start your child at a low dose and slowly increase.

Felbatol: Felbatol is only approved for children 14 and older and is used to treat partial epilepsy as adjunctive and monotherapy, and is approved as adjunctive therapy for generalized epilepsy associated with Lennox-Gastaut syndrome in patients 2 years and older (http://professionals.epilepsy.com/medications/p_felbatol_children.html)

Common side effects include:

• decreased appetite and weight loss,
• nausea,
• insomnia (sleeplessness),
• headache

Other reported side effects are: poor coordination or tremor (shaking), vision problems, dizziness, vomiting, mood changes or anxiety, sleepiness



Oxtellar: Oxtellar is approved for children ages 6 and up as adjunctive therapy in the treatment of partial seizures.

Common side effects include:

• dizziness, sleepiness,
• headache,
• balance problems,
• double vision,
• tremor,
• weakness,
• fatigue, and
• vomiting.

Zonegran: Zonegran has not officially been approved for children. However, studies done in children of varying ages have yielded good results. It has effectively reduced many types of seizures, namely myoclonic, absence, infantile spasms, and generalized seizures.

Most children will not see many side effects, however, side effects are always possible.

Common side effects include:

• loss of balance or coordination.
• dizziness
• drowsiness

More serious side effects include:

• increased or worsening seizures
• pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating
• fever, chills, body aches, flu symptoms, sores in your mouth and throat
• severe pain in your lower back, blood in your urine
• loss of appetite, tired feeling, problems with thinking or speech, trouble concentrating
• feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin without sweating
• the first sign of any skin rash, no matter how mild
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Lamictal: Lamictal is approved for use as adjunctive therapy for partial seizures in children as young as two, and for generalized seizures in children with Lennox-Gastaut syndrome.

Lamictal, when used with Valproate, increases the risk of severe, life threatening rash associated with the medications.

Common side effects include:

tremors, dizziness, tired feeling;

blurred vision, double vision;

loss of coordination;

changes in your menstrual periods;

dry mouth, mild nausea, stomach pain, upset stomach;

back pain;

sleep problems (insomnia); or

runny nose, sore throat.

More serious side effects include:

the first sign of any skin rash, no matter how mild;

fever, swollen glands, body aches, flu symptoms, headache, neck stiffness, increased sensitivity to light;

easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

chest pain, irregular heart rhythm, feeling short of breath;

confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;

pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

increased seizures or worsening of your bipolar disorder

Keppra: Keppra is approved to treat partial onset seizures in children one month of age and older. It has shown to decrease the frequency of other kinds of seizures as well.

Common side effects include:

• mild dizziness or drowsiness
• mild tired feeling
• loss of appetite
• stuffy nose

More serious side effects include:

• hallucinations, unusual thoughts or behavior
• bruising, severe tingling, numbness, pain, muscle weakness
• feeling very weak or tired
• fever, chills, body aches, flu symptoms, sores in your mouth and throat
•  problems with walking or movement
• the first sign of any skin rash, no matter how mild
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Gabitril: Gabitril has been used to treat children with partial seizures and infantile spasms, though it is NOT approved for this purpose. It is approved for children 12 and older.

Common side effects include:

• dizziness, drowsiness, weakness, tired feeling
• feeling restless, irritable, or depressed
• nausea, vomiting, stomach pain, diarrhea
• trouble concentrating
• sleep problems (insomnia)
• lack of coordination
• cough, sore throat
• weight changes

More Serious side effects include:

• new or worsened seizures
• confusion, hallucination
• problems with speech or vision
• severe blistering, peeling, and red skin rash
• tremor
• fever, chills, body aches, flu symptoms
• chest pain, fast heart rate

Trileptal: Trileptal is approved for monotherapy in patients age 4 and over, and for adjunctive therapy in patients ages 2 and over, usually for the treatment of partial seizures. It is considered effective for the treatment of other kinds of seizures.

Common side effects include:

headache, mental slowness, trouble concentrating;

problems with speech, balance, or walking;

dizziness, drowsiness, tired feeling;

mild nausea, vomiting, upset stomach, diarrhea;

blurred vision, double vision;

tremors or shaking; or

skin rash.

More serious side effects include:

increased seizures;

swollen glands, fever, chills, body aches, flu symptoms, sores in your mouth and throat;

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

severe tingling, numbness, pain, muscle weakness;

urinating less than usual or not at all;

chest pain, dry cough, wheezing, feeling short of breath;

upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Topamax: Topamax is approved in the treatment of seizures in children over two as monotherapy and adjunctive therapy.

Common side effects are:

mild dizziness, feeling nervous;

numbness or tingly feeling;

diarrhea, weight loss; or

cold symptoms such as stuffy nose, sneezing, sore throat.

More serious side effects include:

sudden vision loss, pain around or behind your eyes;

dry mouth, increased thirst, drowsiness, decreased sweating, increased body temperature, and hot, dry skin,

confusion, slowed thinking, memory problems, trouble concentrating, problems with speech or balance;

vomiting, loss of appetite, tired feeling, irregular heartbeats, feeling like you might pass out; or

severe pain in your side or lower back, painful or difficult urination.

Neurontin: Neurontin is approved for use in children as young as 3 for threatment of partial seizures.

Common side effects include:

dizziness, drowsiness, weakness, tired feeling;

nausea, diarrhea, constipation;

blurred vision;

headache;

breast swelling;

dry mouth; or

loss of balance or coordination.

More serious side effects include:

increased seizures;

fever, swollen glands, body aches, flu symptoms;

skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

chest pain, irregular heart rhythm, feeling short of breath;

confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;

new or worsening cough, fever, trouble breathing; or

rapid back and forth movement of your eyes.

Some side effects are more common in children:

changes in behavior;

memory problems;

trouble concentrating; or

acting restless, hostile, or aggressive.

Zarontin: Zarontin has been used for many years to treat absence seizures in children. Side effects are usually mild and usually are stomach related.

Common side effects include:

upset stomach, mild nausea, stomach cramps, diarrhea, weight loss;

swelling in your tongue or gums;

headache, dizziness, drowsiness, feeling tired;

lack of balance or coordination; or

unusual vaginal bleeding.

More serious side effects include:

fever, chills, flu symptoms, sore throat, swollen glands, feeling very weak;

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

joint pain or swelling with mild fever, muscle aches, chest pain when breathing;

patchy skin color, red spots, or a butterfly shaped skin rash over your cheeks and nose (worsens in sunlight);

skin rash, severe tingling, numbness, pain, muscle weakness;

confusion, hallucinations, unusual thoughts or behavior, extreme fear;

severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling; or

worsening of seizures.

Dilantin: Dilantin is usually NOT a first choice for children, however some doctors will prescribe it when they find it necessary.
 The reason for this is a gum disorder called gingival hyperplasia and hirsutism, which occurs in nearly half of children who take Dilantin.

Common side effects include:

mild skin rash or itching;

dizziness, nervousness, sleep problems (insomnia);

nausea, vomiting, constipation; or

headache, joint pain.

Serious side effects include:

swollen glands, easy bruising or bleeding, swollen or tender gums;

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

the first sign of any skin rash, no matter how mild;

confusion, hallucinations, unusual thoughts or behavior;

slurred speech, loss of balance or coordination;

tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;

extreme thirst or hunger, urinating more than usual;

loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

changes in the shape of your face or lips.

Carbatrol: While useful in treating many different kinds of seizures in children, it can worsen others, so correct diagnosis is very important.

Common side effects include:

feeling dizzy, drowsy, or unsteady;

nausea, vomiting, diarrhea, constipation, stomach pain;

headache, ringing in your ears;

dry mouth, swollen tongue; or

joint or muscle pain, leg cramps.

More serious side effects include:

pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

fever, chills, sore throat, mouth and throat ulcers;

easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

confusion, agitation, vision problems, hallucinations;

feeling short of breath, swelling of your ankles or feet;

urinating less than usual;

jaundice (yellowing of the skin or eyes); or

severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

http://www.rxlist.com/lamictal-drug/patient-images-side-effects.htm

http://www.webmd.com/drugs/drug-18053-Keppra+Oral.aspx?drugid=18053&drugname=Keppra+Oral

http://www.drugs.com/sfx/zonegran-side-effects.html

http://www.epilepsyfoundation.org/news/UCB-announces-FDA-approval-for-Keppra-in-infants-and-children-from-one-month-of-age-with-partial-onset-seizures.cfm

http://www.epilepsy.com/medications/b_depakote_children

http://www.drugs.com/sfx/keppra-side-effects.html

http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=aa610e56-1d1d-11e1-8bc2-0800200c9a66

http://www.rxlist.com/oxtellar-xr-side-effects-drug-center.htm

http://www.epilepsy.com/medications/i_gabitril_children

http://www.medicines.org.uk/emcmobile/medicine/10840/spc

http://www.drugs.com/sfx/gabitril-side-effects.html

http://whatmeds.stanford.edu/medications/oxcarbazepine.html

http://www.rxlist.com/trileptal-side-effects-drug-center.htm

http://professionals.epilepsy.com/medications/p_topamax_children.html

http://www.rxlist.com/topamax-side-effects-druhttp://whatmeds.stanford.edu/medications/gabapentin.htmlg-center.htm

http://www.rxlist.com/neurontin-side-effects-drug-center.htm

http://professionals.epilepsy.com/medications/p_zarontin_children.html

http://www.rxlist.com/zarontin-side-effects-drug-center.htm

http://professionals.epilepsy.com/medications/p_dilantin_children.html

http://www.rxlist.com/dilantin-side-effects-drug-center.htm

http://professionals.epilepsy.com/medications/p_carbatrol_children.html