Project Summary
The Patient-Centered Outcomes Research Institute (PCORI) commissioned, via the Agency for Healthcare Research and Quality (AHRQ), a systematic evidence review on interventions for infantile epilepsy. The American Epilepsy Society aims to develop an evidence-based clinical guideline focused on management of infants and children (ages zero to three) with epilepsy.
A seizure is the clinical manifestation of an episode of abnormal electrical activity in the brain. Management options for infant epilepsy include various medications, resective or palliative surgeries, brain stimulation strategies (including but not limited to vagus nerve stimulation), and dietary therapies.
Managing epilepsy in infants and young children is a distinct and important challenge. Epilepsy disproportionately affects children zero to three years compared to other age groups; it is clinically different from epilepsies in older children and adults; it can lead to significant, long-term, negative outcomes for the child; and the population is challenging to treat. In addition, caring for an infant or young child diagnosed with epilepsy can be difficult. Parents and healthcare providers need to balance seizure control with the potential harms of the treatments.
Key Questions
KQ1. What is the effectiveness and comparative effectiveness of pharmacologic treatments for infantile epilepsy?
KQ2. What is the effectiveness and comparative effectiveness of nonpharmacologic treatments for infantile epilepsy (i.e., resective or palliative surgeries, brain stimulation therapies, and dietary therapies), including comparisons to other nonpharmacologic and/or pharmacologic therapies?
KQ3. What are the harms or comparative harms of treatments for infantile epilepsy?
Contextual Questions (CQ)
CQ1. What are the parental preferences for treatment options for infantile epilepsy?
CQ2. What are the harms or comparative harms of not treating infantile epilepsy?