One drug for childhood grand mal: medical audit for three-year remissions.

A comparative study was made of monotherapy for grand mal seizures among four groups of children between three and 14 years of age. The first-choice anticonvulsants were phenobarbitone (N = 159), phenytoin (N = 185), carbamazepine (N = 178) and sodium valproate (N = 63). The proportions in each group with a three-year remission of seizures were, respectively, 22, 34, 40 and 16 per cent. The results were better for children with primary grand mal (25, 39, 45 and 21 per cent) and were worse for those with secondary grand mal (3, 21, 25 and 4 per cent), respectively. 119 of the children obtained no reduction in seizure frequency, and for them there is an urgent need for new and more effective anticonvulsants.