Special considerations in treating children with epilepsy

The incidence of seizures is high in infants and children. Many epileptic syndromes have their onset early in life. The increase in seizure susceptibility of the immature brain may be due to several factors, including an imbalance between excitatory and inhibitory processes, age-specific differences in ionic transport and clearance systems, high incidence of epileptogenic stimuli early in life, and the age-specific expression of pre- and perinatal brain anomalies. All of these factors must be taken into account when developing safe and effective age-specific antiepileptic drugs (AEDs). The use of developmental epilepsy models, followed by clinical trials in children, may help identify such AEDs.