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Clobazam Efficacy as an Add-on Therapy for 121 Patients with Intractable Epilepsy

Ashwaq Al-Sulami

Background: Clobazam is a novel 1,5-benzodiazepine that was initially developed as an antianxiety treatment designed to decrease adverse Effects associated with 1,4- benzodiazepines while maintaining efficacy. It was later found to have antiepileptic properties.

Clobazam is well-tolerated and has shown efficacy as an adjunctive therapy for a variety of epilepsy types, including LGS. Studies have reported tolerance rates as high as 87%. Clobazam has an important antiepileptic effect and is less expensive than the new antiepileptic drugs, but still has not been considered as first- line drug in the treatment of epilepsy. Clobazam have been established as valuable addon medication for refractory epilepsy. Clobazam have been used in our institution for more than 15 years; with benefit observe in many patients.

Methods and Results: Retrospective chart review of patient who were treated with Clobazam between 2008 and 2017 for treatment of intractable epilepsy. The following information were collected; age, sex, seizures type and frequency per month pre-and post Clobazam. Information was entered in Redcap database. 121 patients were reviewed to evaluate the response of seizures to the use of Clobazam. Age mean is 8 years old; male (73) and female (48). The median decrease in the average number of monthly seizures for all patients was 30. The seizures with highest response to Clobazam are myoclonic, atonic, infantile spasm more than generalized tonic clonic and partial seizures. The median decrease in the average monthly seizures following Clobazam was 30 among males and 40 among females no significant association between the sex and the decrease of average monthly seizures following Clobazam. Clobazam presented a stronger effect on younger children compared to the age above 15.

Conclusions: Our study confirmed the efficacy of Clobazam for treatment of intractable epilepsy. Clobazam efficacy more superior in generalized seizures type i.e. myoclonic, atonic, infantile spasm than GTC and partial seizures. Younger children response better than older children.