Current Research for Childhood Epilepsy Is Lacking

Current research for status epilepticus (SE) largely ignores specific treatment for children, according to a study published in the February 2014 edition of Seizure.

In a literature review, Iván Sánchez Fernández, MD, and colleagues at Harvard Medical School analyzed 113 articles pertaining to refractory SE in patients under 18 years old. However, due to limitations in this field, the investigators included adults in some of their research. Additionally, they assessed the progress of the pediatric Status Epilepticus Research Group (pSERG), which aims to compile childhood SE statistics.

The researchers found the medical literature disproportionately focused on the adult treatment of refractory convulsive SE (RCSE), and that those findings were often applied to children.

“No comparative effectiveness trials have been performed in the pediatric population,” they claimed. “Gaps in knowledge include risk factors for SE, biomarkers of SE and RCSE, second- and third-line treatment options, and long-term outcome.”

The investigators said the consequence of insufficient research is that treatment is applied to children based off of adult SE research. However, they noted more solutions are becoming available that could benefit childhood SE patients.

“The answer to this problem is further compounded by the broadening of choice as a result of new intravenous preparations of antiepileptic drugs such as valproate, levetiracetam, or lacosamide,” the authors said, though they mentioned the rarity of the drugs’ use calls for a multicenter analysis on their success rates.

Nevertheless, the researchers touted the implementation of the multicenter pSERG network, which will compile and centralize long-term and genetic information for children with RCSE on a larger scale. According to the study, the pSERG aims to build an infrastructure that will create common protocol and terminology for children with RSCE.

“The pSERG network has developed a set of demographic, clinical, electroencephalography (EEG), neuroimaging, and outcome variables which captures the main aspects of pediatric RCSE diagnosis, management, and outcome,” they concluded.