Clinical trial of minimal treatment for clustering seizures in cases of convulsions with mild gastroenteritis

The aim of this study was to identify means of shortening the treatment period for clustering seizures in patients with convulsions with mild gastroenteritis (CwG). Methods: Sixty-two episodes in 61 patients who presented with CwG managed with carbamazepine (CBZ) or Lidocaine (Lidocaine tape (LDT) or intravenous infusion (Lid-iv)) between November 2005 and October 2008 were studied. The subjects were divided into the following groups: 33 episodes treated with CBZ-1 (5 mg/kg/day, 1 day), 7 with CBZ-3 (5 mg/kg/day, 3 days), 11 with LDT-1 (LDT 2 sheets in 24 h), 4 with LDT-2 (LDT 2 sheets in 48 h), and 7 with Lid-iv (1 mg/kg/h, continuous infusion). Results: One to seven seizures were recognized before starting CBZ or Lidocaine therapy, followed by complete cessation in 57 episodes and one or two recurrent seizures in five. Efficacy rates were 97% for CBZ-1, 100% for CBZ-3, 72.7% for LDT-1, 75% for LID-2, and 100% for Lid-iv. Efficacy was significantly higher in the CBZ groups than the Lidocaine groups (p = 0.019), while the differences between treatment periods (CBZ-1 vs. CBZ-3, and Lid-1 vs. Lid-2) did not reach statistical significance (p > 0.999). Conclusions: CBZ and Lidocaine were effective for treating clustering seizures of CwG. We confirmed that the treatment period can be shortened without loss of efficacy. Therefore, we consider 1 day therapy with CBZ or Lidocaine to be sufficient.