To study the most efficacious drug combination for drug resistant NHBI cases.

INTRODUCTION: Neonatal hypoglycemia is one of the most common etiology of drug resistant epilepsy and finding the correct drug combination increases efficacy. AIM & OBJECTIVES: To study the most efficacious drug combination for drug resistant NHBI cases. MATERIAL & METHODS : Retrospective study of 75 NHBI cases with drug resistant epilepsy was done. Drug resistance was defined as cases requiring more than 2 appropriate AEDs in correct doses followed up for 2 years. The cases were divided into those on valproate in combination other than lamotrigine, valproate with lamotrigine, clobazam with or without valproate and levetiracetam with or without valproate. Drug was considered efficacious if the child was seizure free or had > 75 % reduction in seizure frequency. RESULTS: Out of 75 cases, valproate without lamotrigine was used in 19 cases of which 26 % were seizure free, 36 % had >75% seizure reduction and 15% had <75% and 26 % had no change in seizure frequency. Combination of lamotrigine and valproate used in 44 cases, 36% were seizure free, 13% had >75% & 15.9% had <75% reduction and no benefit in 25%. Clobazam used in 49 cases of which 30% were seizure free, 32% > 75% & <75% in 14 % & no benefit in 22 %. Out of 42 cases on levetiracetam, 16% were seizure free, 30% > 75%, 33% <75 % reduction and 19 % no change in frequency. CONCLUSION: Combination of valproate and lamotrigine is the most efficacious for drug resistant NHBI cases.