3 antiseizure drugs show effectiveness in Angelman children, study says
Commonly prescribed medications usually reduce seizure frequency
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Three commonly prescribed antiseizure medications are usually effective at reducing the frequency of seizures among children with Angelman syndrome, according to a new study.
Findings showed that most children with Angelman experience at least a 50% reduction in seizure frequency after starting any of ethosuximide, levetiracetam, and valproate. Side effects seen among children with Angelman are in line with the known profile of each medication in the general population.
The study, “Treatment responses to antiseizure medication in children with Angelman syndrome,” was published in the European Journal of Paediatric Neurology.Â
‘We found convincing seizure reduction rates’
Angelman syndrome is a genetic disorder caused by mutations affecting the copy of the UBE3A gene that is inherited from a person’s biological mother. Seizures — uncontrolled bursts of brain activity, which can manifest as symptoms ranging from twitches to loss of consciousness — are a common symptom of Angelman, affecting most people living with the disorder.
A variety of antiseizure medications are widely available. Broadly, these medicines work to limit the excess brain activity that triggers a seizure. Antiseizure medications may be given to help reduce seizure risk in people with Angelman, but the impact of these medications — and the comparative benefits and risks of specific drugs — has not been thoroughly studied among people with this condition.
To learn more, researchers analyzed data from 101 children with Angelman who received care at Angelman Center Munich in Germany between 2019 and 2025. Three-quarters (75%) of the children had a history of seizures. The researchers noted that seizures were most common in children with a deletion of the maternal UBE3A gene. In most cases, seizures were first documented in infancy or early childhood, with more than 90% of patients experiencing their first seizure by age 5.
Most of the children with a history of seizures did not experience seizures frequently: 62% reported seizures every six months or less often. However, 17% reported monthly seizures, 11% reported weekly seizures, and another 11% had daily seizures. Of note, children younger than 5 were most likely to have high seizure rates, whereas seizure rates were generally lowest among tweens and teens. This finding “supports prior findings from longitudinal studies that epilepsy [seizures] often improves from infancy to adulthood” in children with Angelman, the researchers wrote.
We recommend selecting antiseizure medication according to the individual … in accordance with international guidelines.
Many of the patients had received at least one antiseizure medication. The most commonly used were ethosuximide, levetiracetam, and valproate. For each of these three agents, the researchers assessed response rates, defined as the number of participants who experienced a reduction in seizure frequency of at least 50% after starting treatment.
Response rates were 78% with ethosuximide, 64% with levetiracetam, and 75% with valproate. In other words, with all three medications, most patients experienced a notable reduction in seizure frequency following treatment.
“We found convincing seizure reduction rates for valproate and ethosuximide, closely followed by levetiracetam,” the researchers wrote.
Side effects associated with each of these three medications were generally consistent with their known profiles. For example, ethosuximide can cause digestive complaints, levetiracetam can trigger worsening of behavioral issues, and valproate can lead to tremor and elevated liver enzymes. Rates of discontinuation due to side effects were similar across all three medications (14% or 15%).
Overall, these data suggest that all three of these medications may be suitable options for children with Angelman syndrome who are experiencing seizures.
“We recommend selecting antiseizure medication according to the individual … in accordance with international guidelines,” the researchers wrote. “Close monitoring of treatment response and tolerability, along with clear communication with caregivers about potential side effects is essential for [ensuring continuous treatment] and optimizing outcome.”
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