The clinical use of blood dosages of antiepileptic drugs in a pediatric population is discussed. This study is focused on three main problems: 1) Analysis of the causes affecting the relationship between posology and blood levels of antiepileptic drugs. The significance of age and pharmacologic interaction are stressed. 2) Critical discussion of the meaning of therapeutic range. It is confirmed that, especially in pediatric age, it is not possible to establish a clear cut parallelism between blood level and therapeutic response. 3) Study of the relationship between blood level and side effects; chronic effects on hepatic function are specially considered.

Adolescent↗

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[Prognosis of febrile seizures correlated wih age of onset and therapeutic response (author's transl)].

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Age Factors↗

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[Neurological and psychic side effects of antiepileptic drugs in pediatric age (author's transl)].

Neurological and psychic side effects of anticonvulsivant drugs in pediatric age are separately considered. Neurological side effects are classified according to different ages: in the neonatal period sedation is preeminent, later psychomotor deterioration or cerebellar and/or extrapyramidal signs may occur. Less frequently antiepileptic drugs are responsible of worsening of seizures up to a toxic encephalopathy. Psychic side effects are more variable and unpredicatable. The same drugs can cause both psychomotor excitement or psychic slowness. In a few instances psychotic syndromes can be observed. Very important are chronic side effects on intellectual activities, especially in children. Finally some factors which can affect the interpretation of the side effects have to be considered: pharmacokinetic data individual reactivity, methodology of evaluation of clinical symptoms, especially psychic ones.

Age Factors↗