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    Home > Active Ingredient News > Study of Nervous System > Children’s epilepsy should be diagnosed and treated sooner rather than later, and guard the "electric little angel" with love

    Children’s epilepsy should be diagnosed and treated sooner rather than later, and guard the "electric little angel" with love

    • Last Update: 2021-03-27
    • Source: Internet
    • Author: User
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    *Only for medical professionals to read for reference.
    Children with epilepsy are "little angels with electricity" and can live normally like normal children through standardized treatment.

    Epilepsy is the most common neurological disease in childhood, and the overall prevalence rate in my country is about 7‰[1].

    Among China's 10 million patients with epilepsy, 60% originated in childhood.

    Of the 400,000 new epilepsy patients each year, more than half are children and adolescents.

    Children's cerebral cortex function development is not yet complete, and the blood-brain barrier function is weak, so it is more likely to cause strong brain excitement, which leads to abnormal discharge of brain nerve cells, becoming "charged little angels.
    "
    Figure 1: Demonstration of abnormal brain discharge in children with epilepsy treatment needs to grasp the golden treatment period.
    Children with sudden convulsions, muscle twitches and even cognitive impairment.
    Long-term and frequent abnormal discharges can cause brain damage and even persistent neuropsychiatric disorders [2 ].

    Jiang Yuwu, director of the Pediatrics Department of Peking University First Hospital, said that epilepsy in children is controllable and treatable and should be diagnosed and treated early.

    The treatment of epilepsy in children needs special attention, and strive to control seizures before the language development period of 4-5 years old, so as to win precious language development opportunities for children.

    More than 60% of childhood-onset patients can effectively control epileptic seizures and return to normal life through standardized treatment and rational drug use.

    Drug therapy is currently the most commonly used treatment method.
    Its main advantage is convenience, and most patients have a definite effect.

    Approximately 50% of children can effectively control seizures with one medication.

    Children with epilepsy have their own characteristics.
    Most of the children are young at onset, have imperfect liver and kidney function development, and have poor metabolism and excretion of drugs.
    Drugs are easy to accumulate and cause adverse reactions.

    Childhood growth and development are fast, and the daily dose should be calculated according to the kilogram body weight within the standard weight range, so accurate doses of drugs are required.

    Children at an important stage of growth and learning, when choosing antiepileptic drugs, should fully consider the impact on children's cognitive function [3].

    Behavioral problems in children with epilepsy can lead to decreased treatment compliance, affect the treatment effect, and are more likely to develop into refractory epilepsy [4].

    When choosing antiepileptic drugs, you should consider choosing antiepileptic drugs that have little effect on behavior as much as possible.

    The third-generation anti-epileptic drug-Lacosamide has a strong control of seizures and good safety.
    Lacosamide is currently the only highly selective blocker that acts on the slow inactivation of sodium ion channels.

    The mechanism promotes the sodium ion channel to enter the slow inactivation state, reducing or blocking the generation of action potentials; and increasing the voltage-gated sodium channel in the slow inactivation state to the maximum ratio, reducing the overall availability of the channel, and helping to terminate the epileptic discharge Long-range high-frequency discharge in the process [5].

    Figure 2: Mechanism of action of lacosamide Lacosamide was approved in January 2021 for the monotherapy of partial seizures of 4 years old and older.

    The approval of this indication brings more choices for newly diagnosed children with epilepsy.

    A retrospective study conducted in my country included 72 children with epilepsy with an average age of 7 years.

    The results showed that the proportion of children treated with lacosamide monotherapy was as high as 50% without seizures at 12 months.

    And the earlier lacosamide is included in the treatment, the more obvious the effect [6].

    Figure 3: The results of the trial: Lacosamide treatment in children with epilepsy also has good safety.
    Adverse events are mostly mild to moderate.
    The incidence and severity of adverse events decrease with time, and they are unhealthy after entering the maintenance period.
    The incident rate is reduced [7].

    Lacosamide can effectively control epileptic seizures, while at the same time it can significantly improve cognitive function.
    The formulation is friendly and easy to take for children.
    94 epilepsy patients were enrolled in a study.
    Lacosamide or perampanel was used as an additive treatment.
    The median follow-up was 36 weeks to explore the effects of long-term use of the two drugs on the cognitive function of patients with epilepsy.

    The results showed that lacosamide significantly improved patient executive function and verbal memory [8].

    Children have difficulty swallowing medicines, especially infants and young children who take tablets or capsules.

    Therefore, there is a clinical need for a dosage form suitable for children, which is convenient for children to take, and at the same time, accurate medication is required according to the child's kilogram weight.

    The oral solution dosage form is more in line with the needs of children's clinical medication.

    Lacosamide oral solution is bioequivalent to tablets, and the two dosage forms can be switched at equal doses and frequency, making clinical use easier [9].

    The lacosamide oral solution is equipped with a measuring cup and oral dosing device, which can be easily used by all kinds of patients, and the dosage is more accurate.

    Most children with epilepsy can control their seizures and even cure them through treatment, and they can grow up happily like other children.

    Failure to receive timely and standardized treatment and control will seriously affect the growth and development and physical and mental health of the child, wear down the child’s will, hit the child’s self-esteem, and cause some irreversible damage.

    Early and standardized treatment of childhood epilepsy can effectively control the seizures of epilepsy, allowing the "charged little angel" to return to a healthy person's life as soon as possible.

    References: [1] Bao Xinhua.
    Research progress in epidemiology of epilepsy [J].
    Journal of Practical Pediatrics Clinical Medicine, 2011, 26(12): 897-899.
    [2] Qin Jiong, Wang Hua, Yang Yanling, et al.
    Expert consensus on the application of L-carnitine in the treatment of childhood epilepsy (formulated in 2018) [J].
    Chinese Journal of Practical Pediatrics, 2018, 33(8): 561-565.
    [3] Clinical Diagnosis and Treatment Guidelines for Epilepsy (2015 revised edition).
    [4] Mitchell WG, et al.
    Epilepsia.
    2000; 41(12): 1616-25.
    [5] Rogawski MA, et al.
    Epilepsy Res.
    2015 Feb; 110: 189-205.
    [6] Ting Zhao, et al.
    Epilepsy Behav.
    2021 Feb 18; 117: 107814.
    [7] Farkas V, et al.
    Neurology.
    2019; 93(12): e1212-e1226.
    [8] Meschede C, et al.
    Seizure.
    2018 May; 58:141-146.
    [9] Cawello W, et al.
    Epilepsia, 54(1): 81–88, 2013.
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