REVIEW
Alternative approaches to conventional antiepileptic drugs in the management of paediatric epilepsy
1 Child Development Centre, Department of Neurology, Alder Hey Children’s Hospital, Liverpool, L12 2AP, UK
2 Roald Dahl EEG Unit, Department of Neurology, Alder Hey Children’s Hospital, Liverpool, L12 2AP, UK
Correspondence to:
Correspondence to:
Dr Richard Appleton
Roald Dahl EEG Unit, Department of Neurology, Alder Hey Children’s Hospital, Liverpool, L12 2AP, UK; richard.appleton{at}rlc.nhs.uk
Over the last two decades, there has been a rapid expansion in the number and types of available antiepileptic drugs (AEDs), but there is increasing concern amongst parents and carers about their unwanted side effects. Seizure control is achieved in approximately 75% of children treated with conventional AEDs, but non-conventional (or non-standard) medical treatments, surgical procedures, dietary approaches, and other non-pharmacological treatment approaches may have a role to play in those with intractable seizures or AED toxicity. Many of the approaches are largely common sense and are already incorporated into our current practice, including, for example, avoidance techniques and lifestyle advice, while others require further investigation or appear to be impractical in children.
Abbreviations: ACTH, adrenocorticotrophic hormone; AED, antiepileptic drug; CBT, cognitive behaviour therapy; ESES, electrical status epilepticus during slow wave sleep; GABA, gamma butyric acid; IVIG, intravenous immunoglobulin; KD, ketogenic diet; LKS, Landau-Kleffner syndrome; MCT, medium chain triglyceride; NCSE, non-convulsive status epilepticus; OD, oligoantigenic diet; RCT, randomised controlled trial; RS, Rasmussen’s syndrome
Keywords: alternative treatment; complementary treatment; epilepsy; non-pharmacological treatment; psychological treatment
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Arch. Dis. Child. 2006 91: e7.
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