Abstract Details

Title Prescribing Practices and Antiepileptic Drug Choice in Benign Epilepsy with Centrotemporal Spikes

Topic Child Neurology and Developmental Neurology

Presentation(s) P16 - Poster Session 16 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-014

Objective We sought to evaluate AED prescribing practices and compare the efficacy on seizure control and tolerability of varied AED regimens versus no treatment.

Background Much debate exists regarding appropriate treatment of Benign Epilepsy with Centrotemporal Spikes (BECTS). The literature varies between choices of antiepileptic drug (AED) or not using AEDs.

Design/Methods A retrospective cohort study included patients ≤18 years of age with a diagnosis of BECTS (based on ICD9/10 codes and/or documentation in the note) who were evaluated at Texas Children’s Hospital from 2011-2018. Demographics, AEDs, medical history, electroencephalograms, brain imaging, and medical reports were reviewed.

Results A total of 298 charts were queried, with 159 patients (51.6% male) meeting inclusion criteria. Mean age of seizure onset was 6.7 years. When a BECTS diagnosis was established, AEDs were started/continued in 102 (64.2%), not started in 44 (27.7%), and stopped in 13 (8.2%). Patients started on AEDs were more likely to have experienced status epilepticus and had a higher seizure burden than patients not started on AEDs (p-values < 0.05). The most commonly prescribed AEDs were oxcarbazepine (66.7%), levetiracetam (18.6%), carbamazepine (7.8%), zonisamide (6.9 %), topiramate (2.9%) and lamotrigine (2.9%). Incidence of side effects was least in levetiracetam (21.7%) and lamotrigine had the highest incidence (71.4%). Thirty-five patients were weaned off their AED subsequent to 25.4±14.6 months of seizure freedom.

Conclusions Substantial practice variation exists at a single institution regarding AED prescribing in treatment of BECTS. Oxcarbazepine was the most commonly prescribed AED. Side effects were commonly reported in this cohort to all AEDs.

Authors/Disclosures
Mariam Hull, MD (Texas Children's Hospital, Pediatric Neurology) PRESENTER	Dr. Hull has received publishing royalties from a publication relating to health care.
Robert C. Stowe, MD (Boston Children's Hospital)	An immediate family member of Dr. Stowe has received personal compensation for serving as an employee of Sanofi Genzyme. Dr. Stowe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda Pharmaceuticals. An immediate family member of Dr. Stowe has or had stock in Sanofi Genzyme.Dr. Stowe has received personal compensation in the range of $5,000-$9,999 for serving as a Course Leader/Educator with RealCME.
Jon A. Cokley, PharmD (Texas Childrens Hospital)	An immediate family member of Dr. Cokley has received personal compensation for serving as an employee of Johnson and Johnson Vision. Dr. Cokley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xenon Pharmaceuticals. Dr. Cokley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Wolters Kluwer. Dr. Cokley has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Pharmaceuticals. Dr. Cokley has received publishing royalties from a publication relating to health care. Dr. Cokley has a non-compensated relationship as a Board of Trustees with Neurocricitical Care Foundation that is relevant to AAN interests or activities.
Imad T. Jarjour, MD, FAAN	No disclosure on file

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