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Rectal anticonvulsants in pediatric practice.

Children with seizure disorders frequently are treated with anticonvulsant medications such as clonazepam, valproic acid, carbamazepine, and ethosuximide, which cannot be given parenterally. When the child is unable to take these anticonvulsants orally, he or she may be given parenteral doses of phenobarbital or phenytoin. In many cases, these two medications have failed previously to control seizures, leading to the use of the more recently developed drugs. The use of rectal preparations of some anticonvulsant medications is highly useful and effective when the child is unable to take oral medications because of repeated vomiting, gastrointestinal surgery, and status epilepticus associated with lack of venous access. Rectal use of anticonvulsants has a role in the management of hospitalized seizure patients and can be learned by parents needing to treat their children's seizures at home while awaiting other medical care.