ZUSAMMENFASSENDER ERFAHRUNGSBERICHT ÜBER DIE KLINISCHE ANWENDUNG UND WIRKSAMKEIT VON Ro 5‐4023 (CLONAZEPAM) AUF VERSCHIEDENE FORMEN EPILEPTISCHER ANFÄLLE

Ro 5-4023 was administered orally and intravenously. Oral long-term therapy of at least one month (average 10 months) was given to 100 patients, mainly children aged up to 14 years (90 per cent of cases) with cerebral damage since early infancy. Most were suffering from severe epilepsy of early childhood, which had proved resistant to former treatment. The principal form was myoclonic-astatic seizures (67 per cent) often combined with tonic seizures or grand mal. The initial effect of the long-term treatment was satisfactory, especially in non-major seizures (positive initial effect in 62 per cent), although in general freedom from seizures was not obtained, but only an improvement in their frequency. The incidence of recurrences in the further course was high, however, and after 6–12 months of treatment the positive effect of clonazepam was below 30 per cent, i. e. within the range of chance in the spontaneous course of epilepsy. After the patient had relapsed and oral long-term therapy had been withdrawn it was in many cases still possible to exploit the immediate effect of small oral doses taken “as needed”, i. e. only on days in which there was a particular clustering of petit mal fits or a tendency towards petit mal status. Apart from untoward psychic side effects and, very rarely, activation of tonic seizures, no serious side effects were seen. The immediate effect of intravenous administration on various forms of status epilepticus (without grand mal status) was good, and a positive effect was obtained in 75 per cent of cases. The positive clinical effect of a single intravenous dose lasted for more than 24 hours in 60 per cent of cases. On the whole clonazepam has shown itself to be a “broad-spectrum” anti-epileptic agent with a wide range of indications, which in spite of the often purely palliative effect and high rate of recurrence is particularly suitable for the treatment of severe, combined epilepsies and their status forms.