Effectiveness of Clonazepan in Startle‐induced Seizures

Abstract

Cerebral-palsied children (5) and adolescents with severe startle epilepsy became seizure-free after clonazepam was added to their existing anticonvulsant drug regimens. The drug was withdrawn in 1 case because of side effects. Hemiparetic patients (2) had startle epilepsy as the only epileptic manifestation remained permanently controlled after a mean of 34 mo. of continuous therapy. Startle-induced seizure reappearance occurred after 1 and 4 yr in 2 other patients with the Lennox-Gastaut syndrome. A possible explanation for clonazepan effectiveness in this reflex epilepsy form may involve inhibition of brainstem mechanisms mediating pathologically enhanced patient reactions, thus avoiding secondary activation of a discharging focus in the vicinity of the motor supplementary area.