EMERGING APPROACHES IN PEDIATRIC EPILEPSY MANAGEMENT: A NARRATIVE REVIEW

Abstract

Background: Pediatric epilepsy is a prevalent neurological disorder that significantly impacts cognitive, behavioral, and psychosocial development in children. While antiseizure medications (ASMs) remain the mainstay of treatment, approximately one-third of pediatric patients experience drug-resistant epilepsy (DRE), highlighting the need for alternative and individualized treatment strategies.

Objective: This narrative review aims to explore recent advances in pharmacological and non-pharmacological treatment approaches for pediatric epilepsy, emphasizing emerging therapies such as dietary interventions and neuromodulation techniques.

Main Discussion Points: The review synthesizes evidence on second-generation ASMs, which offer improved tolerability and tailored treatment options. Non-pharmacological strategies, including the ketogenic diet, vagus nerve stimulation, and physical activity, are discussed for their efficacy in reducing seizure frequency and enhancing quality of life. The review also highlights the integration of genetic insights into treatment planning and the trend toward multimodal, personalized care. Critical limitations in current literature—such as small sample sizes, lack of randomized controlled trials, and variability in outcome measures—are examined to contextualize the strength of evidence.

Conclusion: Emerging therapies present promising options for children with epilepsy, particularly those unresponsive to conventional medications. Clinicians should adopt individualized, evidence-informed strategies, while researchers are encouraged to conduct robust, inclusive trials to strengthen clinical guidelines and optimize patient outcomes.