Some Children With Dravet Improved on Cenobamate

What was studied

This report described 2 pediatric patients with Dravet syndrome associated with SCN1A variants who were treated with cenobamate as an add-on antiseizure medicine.

One was a 7-year-old girl with severe developmental impairment who took cenobamate along with valproate, clobazam, and cannabidiol. The other was a 17-year-old adolescent male with generalized tonic-clonic seizures and daily eyelid myoclonia who took low-dose cenobamate.

What they found

Both patients were reported to have improvement with cenobamate. The 7-year-old girl had an 80% reduction in total seizures at a maintenance dose, and her generalized tonic-clonic seizures were markedly reduced. When cenobamate was tapered, her seizures increased nearly back to the pre-cenobamate state, and when the medicine was returned to stable maintenance levels, seizures improved again; the report states that no generalized tonic-clonic seizures were noted since October 2025. The 17-year-old adolescent male was reported to have seizure suppression on 50 mg/day, with one breakthrough generalized tonic-clonic seizure after a missed evening dose, and no adverse effects were reported. The authors say these cases add to earlier mixed pediatric reports, including reports with no responders and frequent worsening.

Limits of the evidence

This was only a 2-patient case report, so it cannot show how cenobamate will work for most children with Dravet syndrome or how safe it is overall. There was no comparison group, and both patients were also taking other antiseizure medicines, so the specific contribution of cenobamate cannot be determined from this report alone. The abstract gives limited detail about follow-up and adverse effects. Because earlier pediatric reports have included seizure worsening, these cases do not show that cenobamate is broadly beneficial in pediatric Dravet syndrome.

For families and caregivers

For families, this report suggests that cenobamate may help some children or adolescents with Dravet syndrome, even though chronic sodium-channel blocker treatment is classically considered aggravating in this condition. At the same time, the evidence here is very limited, and other pediatric reports have found no responders or frequent worsening. This means the medicine may be something to discuss carefully with a specialist in selected cases, but these 2 cases alone are not enough to predict what will happen for most children.

What to watch next

Stronger evidence would come from larger controlled pediatric studies that assess both possible seizure reduction and the risk of seizure worsening over time.

Terms in this summary

Dravet syndrome

A severe epilepsy syndrome that usually begins in infancy and often causes multiple seizure types and developmental difficulties.

SCN1A

A gene involved in sodium channel function; loss-of-function variants in this gene are a common cause of Dravet syndrome.

sodium-channel blocker

A type of medicine that affects sodium channels, which help nerve cells send signals.

adjunctive therapy

A treatment used in addition to other medicines, not by itself.

generalized tonic-clonic seizure

A seizure with body stiffening and jerking movements, often with loss of awareness.

eyelid myoclonia

Brief, repeated jerking or fluttering of the eyelids.

maintenance dose

The regular dose used after the medicine has been adjusted to a stable level.