Insights into neurologists’ practices and preferences in pharmacological management of paediatric epilepsy: a real-world survey-based study from India

Background: Epilepsy is a chronic brain disorder marked by recurrent seizures. Many children experience a mild form that resolves naturally, while others have persistent cases requiring lifelong medication. In India, prevalence of paediatric epilepsy is about 0.8%. The objective of this survey was to explore neurologist’s practices in the pharmacological management of paediatric epilepsy. Methods: The cross-sectional, questionnaire-based, real-world survey was conducted amongst 245 neurologists across India from August 2024 to September 2024. The respondents were administered a validated 20-question survey. Analysis of the data was conducted in Microsoft Excel (365, Version 22502). Graphical representations were created to highlight significant trends and treatment preferences. Results: In the survey, 43.7% of the neurologists reported that they examine around 5 to 10 cases per month, and majority (44.0%) of them also noted 2-to-6-year age group was most affected with the disease. Levetiracetam has emerged as the most preferred antiepileptic drug, with 42.1% of respondents using it for focal epilepsy, 42.4% for generalized epilepsy and 46.5% for myoclonic seizures. Syrup formulations were preferred by 93.9% of neurologists, with levetiracetam syrup at a dose of 10mg/kg twice a day being the most commonly preferred in the management of paediatric epilepsy. Conclusions: The survey indicates rising trend in paediatric epilepsy cases in India. Levetiracetam was the frequently chosen drug for the treatment of focal, generalized and myoclonic seizures in children with epilepsy. In addition to its rapid onset of action and low frequency of drug-drug interactions, it was also favoured for its versatility in terms of dosage formulation, especially in the syrup form.