Abstracts

RATIONALE:Bromide is an old- fashioned anti- epileptic medication which is little used. The aim of this study is to ascertain the effectiveness and safety profile of this drug. METHODS: Retrospective case note review. RESULTS: Forty- nine patients were studied (25 male, 24 female). Age at review ranged from 2.5- 21.8 years (mean 10.4 years). Thirty had symptomatic localisation related seizures, 10 severe myoclonic epilepsy of infancy, 7 cryptogenic and 2 partial epilepsy. An average of 5 medications had been tried previously. The average therapeutic dose was 59 mg/kg/day (10-160 mg/kg/day). A greater than 75% reduction in seizures was seen in 21 (43%), 50-75% in 8(16%) and 25-49% in 3(6%). Seizure frequency was unchanged in 14(29%). There were no data on frequency in 6. The type of seizure or epileptic syndrome did not appear to predict efficacy. Twenty- six(53%) remained on therapy at the time of study. The average length of time of therapy was 18 months(1- 80 months). Twenty- one(43%) reduced or stopped all other medication while on treatment. Reasons for discontinuation of bromide included ineffectiveness in 14(29%), and tolerance in 3(6%). Adverse effects occured in 13(27%) necessitating in discontinuation of treatment in 5(10%). Four experienced a classical acneiform rash, two possible bromism, one patient each experienced poor growth/ muscle wasting, peripheral oedema, tinnitus, nausea, poor balance, early morning tiredness and distressed behaviour. CONCLUSIONS: This study concludes bromide is safe and effective and should be considered in the management of paediatric epilepsy.