Low-dose carbamazepine therapy for benign infantile convulsions

Benign infantile convulsions (BIC) are characterized by: (1) onset at up to 2 years of age, (2) normal development, (3) mostly brief, often clustered convulsions, and (4) normal electroencephalography during the interictal stage. BIC follow a favorable course and disappear before 2-3 years of age, although convulsions for which diazepam is ineffective frequently develop. We treated 15 children (3-16 months of age) diagnosed as having BIC, excluding convulsions associated with mild gastroenteritis, with a once-daily dose of 5 mg/kg of carbamazepine until up to 2 or 3 years of age. The serum concentration of carbamazepine was as low as below the effective range in six patients, but the treatment was dramatically effective in all the BIC children. Seizures did not recur in any patients during oral administration of carbamazepine. The treatment was finished in 12 patients at age 2 years, two at age 3 years, and one at 16 months-old. Therefore, we recommend the administration of a once-daily dose of 5 mg/kg of carbamazepine until up to 2 or 3 years of age as a treatment for BIC.