Lennox-Gastaut syndrome (LGS) is a form of childhood epileptic encephalopathy that continues to be challenging to treat and manage. The available treatments have failed to provide good control for patients with this devastating epilepsy syndrome. Clobazam is a promising antiepileptic medication, given its effectiveness and relatively low rates of adverse effects. It has been studied and used in several countries for the treatment of refractory seizures, including those that occur with LGS. Clobazam (Onfi™; Lundbeck Inc., IL, USA) has been studied in the USA to demonstrate its efficacy and safety for the treatment of seizures associated with LGS, and Phase II and III trials have recently been completed. This article will explore the use of clobazam in the treatment of LGS and present the results of Phase II and III studies, along with an overall summary of the treatment of LGS, as well as the possible role of clobazam in a treatment algorithm. We based this article on the most relevant reports with the term 'clobazam' found through a Medline search (1966-2011).

Status epilepticus (SE) is a neurologic emergency that require immediate vigorous treatment in order to prevent serious morbidity or even death. Several investigators have suggested that the underlying etiology is the primary determinant of outcome. We believe that this may be true in aggressively treated SE, but not when the treatment is less than optimal. In this article, we will discuss the factors that have been implicated in affecting SE outcomes, and argue, on the basis of both human and experimental animal data, that aggressive treatment is necessary and appropriate for all presentations of SE in order to maximize the probability of a successful outcome even when the etiology suggests a poor prognosis.