A group of 24 experts (two of whom practice in France), members of five European reference networks, used the Delphi method to draw up recommendations for the treatment of epilepsy in primary mitochondrial diseases:
- consensus was rapidly reached on the safe use of 14 of the 25 antiepileptic drugs studied for children and adults;
- for the remaining 11, consensus was reached on their lack of contraindication in primary mitochondrial disease,
- with the exception of valproic acid in POLG deficiency, vigabatrin in patients with γ-aminobutyric acid transaminase deficiency and topiramate in patients at risk of renal tubular acidosis.
Synthetic diagrams present the different therapeutic options for focal seizures, generalized seizures, myoclonic seizures and status epilepticus in children and adults.
However, the experts stress the importance of tailor-made prescribing, under close supervision to detect the slightest undesirable effect.
