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Myoclonic Epilepsy Beginning in Infancy or Early Childhood Medication

  • Author: Michael C Kruer, MD; Chief Editor: Amy Kao, MD  more...
 
Updated: Mar 14, 2016
 

Medication Summary

The long-term goals of pharmacotherapy are to reduce morbidity and prevent complications.

Go to Antiepileptic Drugs for complete information on this topic.

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Antiepileptic Drugs

Class Summary

These agents prevent seizure recurrence and terminate clinical and electrographic seizure activity. Patients with the benign form of myoclonic epilepsy often respond very well to first-line AEDs.

Valproic acid (Depakote, Depakene, Depacon, Stavzor)

 

Valproic acid is chemically unrelated to other drugs that treat seizure disorders. Although its mechanism of action not established, its activity may be related to increased brain levels of gamma-aminobutyric acid (GABA), or enhanced GABA action. Valproate also may potentiate postsynaptic GABA responses, affect potassium channels, or have direct membrane-stabilizing effect.

The use of valproic acid in young children (younger than 2 y) is associated with an increased risk of hepatotoxicity. Hepatotoxicity is estimated to occur in fewer than 1 in 250 children treated.

Clonazepam (Klonopin)

 

Clonazepam facilitates inhibitory GABA neurotransmission and other inhibitory transmitters. It is useful in immediate control of seizures, but it may be associated with relatively rapid loss of efficacy against seizures.

Ethosuximide (Zarontin)

 

The mechanism of action of ethosuximide is based on reducing current in T-type calcium channels found on thalamic neurons. Spike-and-wave patterns during petit mal seizures are thought to be initiated in thalamocortical relays by activation of these channels. Ethosuximide is used as adjunctive medication to valproic acid if that medication has failed to control seizures.

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Contributor Information and Disclosures
Author

Michael C Kruer, MD Assistant Professor, Departments of Pediatrics and Neurosciences, Sanford School of Medicine, University of South Dakota; Physician in Pediatric Neurology and Neurogenetics, Sanford Children's Specialty Clinic, Sanford Children's Hospital

Michael C Kruer, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Neurology, American Academy of Pediatrics, American Society of Human Genetics, Child Neurology Society, Society for Neuroscience

Disclosure: Nothing to disclose.

Coauthor(s)

Raj D Sheth, MD Chief, Division of Pediatric Neurology, Nemours Children's Clinic; Professor of Neurology, Mayo College of Medicine; Professor of Pediatrics, University of Florida College of Medicine

Raj D Sheth, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American Epilepsy Society, American Neurological Association, Child Neurology Society

Disclosure: Nothing to disclose.

Chief Editor

Amy Kao, MD Attending Neurologist, Children's National Medical Center

Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, Child Neurology Society

Disclosure: Have stock from Cellectar Biosciences; have stock from Varian medical systems; have stock from Express Scripts.

Acknowledgements

James J Riviello Jr, MD George Peterkin Endowed Chair in Pediatrics, Professor of Pediatrics, Section of Neurology and Developmental Neuroscience, Professor of Neurology, Peter Kellaway Section of Neurophysiology, Baylor College of Medicine; Chief of Neurophysiology, Director of the Epilepsy and Neurophysiology Program, Texas Children's Hospital

James J Riviello Jr, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Up To Date Royalty Section Editor

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

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