Rufinamide Experience in Childhood Epilepsy from a Tertiary Center, Turkey

Objective: To evaluate the efficacy of rufinamide by electro-clinical and treatment responses in childhood epilepsy from a tertiary pediatric reference center. Material and Method: A cohort of 45 children with ‘refractory’ epilepsy who were received oral rufinamide as add-on therapy between July 2014 and October 2021 were evaluated retrospectively. Demographical and electro-clinical features of the patients were evaluated from the hospital records. Therapeutic response was recorded by evaluating seizure frequency and seizure duration after initiating rufinamide. Results: The cohort consisted of 40% males and 60% females, aged 3 years-20years (mean 10.1, sd 4.8 years). 35,6% had West Syndrome , % 15,6 children had Lennox-Gastaut Syndrome with multiple seizure types, 22,2% of patients had frontal lobe epilepsy and 13,2% had occipital, temporal lobes and miyoclonic atonic epilepsy, also 13.4% of them were unclassified. The seizure frequency, severity and duration was decreased by more than 50% in 28.8 of the patients and 46% of these patients were diagnosed LGS. Seizure freedom was achieved in 2 (4.4%)patients and they had focal epileptic activity on EEG. There was not any significant EEG improvement in terms of epileptiform discharges in any of the patients.

Conclusion: Rufinamide is a well-tolerated, safe, and very effective antiepileptic drug in focal childhood epilepsy with a broad spectrum of antiepileptic activity, especially treatment response is better in LGS. It can be used as add- on therapy earlier in LGS to control seizures where first line anti-epileptics alone prove to be ineffective.