- First-, second-, and third-line antiepileptic drug choices in the three different cases.
| First line | Second line | Third line | ||||
|---|---|---|---|---|---|---|
| n (%) | ||||||
| Case scenario 1 | ||||||
| A 5-year-old boy with spastic quadriplegic cerebral palsy post-HIE with mixed epilepsy, including frequent drop attacks. | ||||||
| Valproic acid | 54 (76.1) | Clobazam | 25 (35.2) | Clobazam | 21 (29.6) | |
| Clobazam | 6 (8.5) | Levetiracetam | 13 (18.3) | Rufinamide | 9 (12.7) | |
| Levetiracetam | 5 (7) | Valproic acid | 12 (16.9) | Clonazepam | 8 (11.3) | |
| Clonazepam | 2 (2.8) | Topiramate | 8 (11.3) | Levetiracetam | 8 (11.3) | |
| Topiramate | 1 (1.4) | Clonazepam | 5 (7) | Topiramate | 6 (8.5) | |
| Other | 3 (4.2) | Other | 8 (11.3) | Other | 19 (26.6) | |
| If a steroid was one of your three treatment options, which of the following steroids would you use? | ||||||
| Not applicable | 37 (52.1) | |||||
| Oral prednisone | 25 (35.2) | |||||
| IV Methylprednisolone | 6 (8.51) | |||||
| ACTH | 3 (4.2) | |||||
| Case scenario 2 | ||||||
| A 4.5-year-old boy with idiopathic epilepsy who developed multiple seizures described as myoclonus and head drops associated with falls. | ||||||
| Valproic acid | 55 (77.5) | Clobazam | 26 (36.6) | Clobazam | 13 (18.3) | |
| Levetiracetam | 8 (11.3) | Levetiracetam | 14 (19.7) | Topiramate | 10 (14.1) | |
| Clobazam | 4 (5.6) | Topiramate | 11 (15.5) | Rufinamide | 10 (14.1) | |
| Clonazepam | 1 (1.4) | Valproic acid | 10 (14.1) | Clonazepam | 7 (9.9) | |
| Topiramate | 1 (1.4) | Lamotrgine | 5 (7.0) | Levetiracetam | 7 (9.9) | |
| Other | 2 (2.8) | Other | 5 (7.0) | Other | 24 (33.7) | |
| If a steroid was one of your three treatment options, which of the following steroids would you use? | ||||||
| Not applicable | 38 (53.5) | |||||
| Oral prednisone | 22 (31) | |||||
| IV Methylprednisolone | 8 (11.3) | |||||
| ACTH | 3 (4.2) | |||||
| Case scenario 3 | ||||||
| A 15-month-old baby with new onset drop attacks. Initial MRI brain and interictal EEG were reported as normal. | ||||||
| Levetiracetam | 31 (43.7) | Clobazam | 25 (35.2) | Topiramate | 17 (23.9) | |
| Valproic acid | 11 (15.5) | Levetiracetam | 14 (19.7) | Valproic acid | 12 (16.9) | |
| Clobazam | 11 (15.5) | Topiramate | 11 (15.5) | Levetiracetam | 10 (14.1) | |
| Clonazepam | 6 (8.5) | Valproic acid | 8 (11.3) | Steroid | 8 (11.3) | |
| Topiramate | 5 (7) | Clonazepam | 8 (11.3) | Clobazam | 7 (9.9) | |
| Other | 7 (9.8) | Other | 5 (7) | Other | 17 (23.9) | |
| If a steroid was one of your three treatment options, which of the following steroids would you use? | ||||||
| Not applicable | 37 (52.1) | |||||
| Oral prednisone | 21 (29.6) | |||||
| IV methylprednisolone | 7 (9.9) | |||||
| ACTH | 6 8.5 | |||||
ACTH – adrenotropic hormone