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Therapeutical efforts in epilepsies with infantile spasms (IS) often show unsatisfying
results, especially if neurological impairments are found. In a clearly negatively
selected group of 24 children with IS and 10 patients with symptomatic myoclonic-astatic
epilepsies—pretreated without success with ACTH and/or benzodiazepines (BDZ) alone
or combined with other anticonvulsants—we tried a two-drug therapy of BDZ with carbamazepine
(CBZ). Dosage of both drugs was within the usual range. In a follow-up period of 1–5
years, 8 of the IS patients and 4 of those with myoclonicastatic seizures became seizure-free;
furthermore, 6 children showed a marked reduction in their seizure frequency: 3 more
than 80%, 3 more than 50%. Besides the fact that the patients did not develop a so-called
escape-phenomenon — as often seen in therapy with benzodiazepines — they also showed
fewer and less intensive side-effects. Without optioning for antiepileptic poly therapy
in general, we conclude that in cases of “intractable” IS the combination of BDZ with
CBZ might be more successful than the single drug. To confirm these preliminary findings
further controlled studies have to be carried out.
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© 1987 Published by Elsevier Inc.
