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Seizure worsening and sodium channel blockers in HCN1-related epilepsies: A case series - PubMed

3 hours ago
  • #Sodium channel blockers
  • #Seizure worsening
  • #HCN1-related epilepsy
  • Pathogenic HCN1 variants are linked to various epilepsies, including drug-resistant developmental and epileptic encephalopathies.
  • Sodium channel blocker antiseizure medications (phenytoin, lamotrigine, oxcarbazepine, lacosamide) worsened seizures in seven patients with gain-of-function HCN1 variants.
  • Discontinuation of sodium channel blockers led to clinical improvement in all cases.
  • The findings highlight a clinically actionable gene-drug interaction, supporting mechanism-based antiseizure medication selection.
  • This evidence aids precision treatment strategies and helps avoid harmful therapies in children with HCN1-related epilepsies.