Preliminary Nigerian experience in the use of carbamazepine in children with intractable seizures.

There is insufficient clinical information about carbamazepine and other newer anticonvulsants from tropical African countries because high costs and limited availability have restricted the use of these drugs in the economically underdeveloped countries. The present communication reports the observed effects of carbamazepine in nine Nigerian children whose epileptic seizures had been intractable to various combinations of previously available anticonvulsants. In seven of these children, intractable seizures were associated with moderate to severe cognitive deficits and behavioral disturbances. Following institution of carbamazepine therapy, complete seizure control was achieved in four children, and significant reduction in seizure frequency occurred in another four. In three children complete seizure control was maintained with carbamazepine alone after withdrawal of all other medications. Among the seven children with cognitive and behavioral problems, improved seizure control was accompanied by significant psychotropic gains. No serious side effects occurred in any of the children during follow-up periods ranging from 2 to 7 years. Because of the favorable anticonvulsant and psychotropic efficacy of carbamazepine in the present study, coupled with the lack of serious side effects, it is recommended that the drug deserves wider use in African children with seizure disorders.