Treatment of seizures in childhood

The field of pediatric epilepsy is a rewarding yet challenging area of medicine. A fairly significant proportion of children remain refractory to current antiepileptic drugs, and may require alternative treatment options. Challenges also arise because many of the antiepileptic drugs available for use since 1993 are US FDA approved only for use over the age of 2-4 years, hence presenting a medicolegal conundrum to the treating physician. However, their more favorable side-effect profile and tolerability have led to their widespread use even in those less than 2 years of age. This review briefly outlines their indications, pharmacokinetic profile and dosages, and covers evidence-based guidelines for therapy in common epilepsy syndromes of childhood.