Abstract
During the last 2 years 37 infants, children and adolescents exhibiting various types of epileptic seizures were treated with clonazepam (Ro 5-4023). The average dosage was about 0.3 mg/kg for infants and about 0.15 to 0.2 mg/kg for the children and adolescents. The initial dose was 1/2 mg/day. Every third day thereafter the dosage was increased by the same amount. For various reasons clonazepam was administered in combination with other anti-convulsants such as barbiturates, phenytoins or hormones in two thirds of the cases. The effect of the drug was evaluated for anti-convulsive effect, convulsion frequency, and psychomotor status. Clonazepam was administered to a group of 4 male infants ranging in age from 4 to 6 months all of them exhibiting infantile spasms. In 2 of the infants seizures were completely eliminated, the EEG patterns were normalized and fair psychomotor progress was observed. Ten patients with Lennox-syndrome (8 boys and 2 girls from 1.9–6.3 years) were treated with clonazepam. There was a total remission of seizures in 2 boys, a fair amelioration in 4. Petit mal seizures were eliminated during treatment in 3 children (2 girls and 1 boy). Convulsions were eliminated in 2 of 3 boys exhibiting focal seizures, and in 3 children from a group of 7 exhibiting mixed seizures (grand mal and petit mal). Clonazepam was administered to 5 children complaining of headaches, vertigo etc. None exhibited convulsions but more or less pronounced spiking activity was observed with all of them. EEG patterns were normalized in 3 of the children, and 2 stopped complaining about their symptoms (placebo effect?). The therapeutic effects are comparable to those produced by nitrazepam (Mogadon®). Also the side effects of clonazepam (hypersalivation, drowsiness etc.) are about the same as those of nitrazepam. In rare cases the children became so drowsy that the treatment had to be terminated. We frequently observed tachycardia lasting 10 to 20 minutes when intravenous injections were administered to treat status. No side effects were observed regarding blood count, serum, and urine status.
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