The antiepileptic drug felbamate has demonstrated efficacy against a variety of 
seizure types in the pediatric population, particularly seizures associated with 
Lennox-Gastaut syndrome. Postmarketing experience, however, revealed serious 
idiosyncratic adverse effects not observed during clinical trials, including 
aplastic anemia and liver failure. As a result, many physicians have been 
hesitant to prescribe felbamate. This retrospective study evaluated the efficacy 
of felbamate in a pediatric population with intractable epilepsy. Of 38 
patients, 22 had Lennox-Gastaut syndrome (58%); 6 had myoclonic-astatic epilepsy 
of Doose (16%); 5 had symptomatic generalized epilepsy, not otherwise specified 
(13%); and 5 had symptomatic localization-related epilepsy (13%). Most patients 
had multiple seizure types and had been tried on a variety of antiepileptic 
medications. With felbamate treatment, 6 patients (16%) became seizure free, 
including 4 of the 6 patients with myoclonic-astatic epilepsy of Doose; 24 
patients (63%) had a greater than 50% reduction in seizure frequency. In this 
population felbamate appeared to be safe, with minimal adverse effects. The 
study is limited by the small number of patients and by its retrospective 
nature, but nonetheless adds to the evidence that felbamate is an important 
antiepileptic drug for medically refractory epilepsy in children and is well 
tolerated with few adverse effects.