Abstracts

Rationale: This retrospective open label study examined the long-term efficacy and safety of oxcarbazepine (OXC) in the long-term use in refractory focal epilepsies. Methods: All patients in whom treatment with OXC was started at our centre before April 1999 (n= 51; mean age 9.4 years, range 1-31 years; age at onset of epilepsy: mean 2.8 years, range 0-13.8 years) were included. We analysed the initial responder rate (as defined as a 50% seizure reduction after 3 months), tolerability and the retention rate after 9 years. We could not obtain reliable information about the initial responder rate in 2 of the 51 patients. All patients had a symptomatic or cryptogenic focal epilepsy, most of them (84.3%) were mentally disabled. Patients were treated with 1-15 (mean 5.6) antiepileptic drugs prior to therapy with OXC. The most frequent combination when OXC was given initially as add-on therapy was VPA plus OXC (52.9%). Results: 3 of the 49 patients died during the observation period of 9 years (in 2 of them death was unrelated to the treatment with OXC; no information with respect to the course of the death could be obtained in the 3rd patient). Two further patients were lost during follow-up. The initial responder rate after 3 months was 63.3% (31 of 49 patients). The retention rate after 9 years was 43.5% (20 out of 46 patients). In 31 patients carbamazepine (CBZ) was replaced by OXC, in 18 cases due to side effects with CBZ which was not observed with OXC in 14 patients. Conclusions: OXC is a drug of first choice in the treatment of refractory symptomatic or cryptogenic focal childhood epilepsies. Compared to our experience with other newer antiepileptic drugs in refractory childhood onset epilepsies OXC was well tolerated and showed a high efficacy in the long-term use. In case of efficacy but the occurrence of side effects with CBZ replacement of CBZ by OXC is recommended.