Effects of various antiepileptic drugs in benign infantile seizures with mild gastroenteritis

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Purpose: This study sought to determine the appropriate choice of antiepileptic drugs (AEDs) for seizures during the acute phase in patients with benign infantile seizures with mild gastroenteritis (BISMG).

Methods: We retrospectively investigated the efficacy and dose of AEDs for BISMG by reviewing the medical records of 42 patients diagnosed with BISMG. In this study, AEDs were regarded as effective when seizures ceased for >24 h after administration.

Results: AEDs were administered to 39 of 42 patients (92.9%). Carbamazepine was effective in 21 of 21 patients (100.0%), phenytoin/fos-phenytoin in three of four patients (75.0%), midazolam in one of two patients (50.0%), lidocaine in one of two patients (50.0%), and diazepam in 13 of 36 patients (36.1%). Intravenous diazepam was effective in seven of 11 patients (63.6%) and suppository diazepam in 10 of 25 patients (40.0%). The median dose of carbamazepine was 5.0 mg/kg/day (range, 3.0-5.0 mg/kg/day) and the median duration of medication was 1 day (range, 1-5 days).

Conclusion: Treatment for 1 day with low-dose carbamazepine was effective for BISMG. Phenytoin/fosphenytoin and intravenous diazepam, not but suppository diazepam, were also effective. We recommend 1 day of treatment with low-dose carbamazepine as the first-line treatment for BISMG. The unnecessary use of AEDs for BISMG should be avoided after the acute phase because seizures in BISMG rarely recur.