The efficacy of gabapentin as an additional medication in 32 children with refractory partial seizures was studied at the Children’s Hospital, Boston, MA. A greater than 50% decrease in seizure frequency was obtained in 34% and a 25% to 50% decrease occurred in 12%. Approximately half the patients were benefited. Doses ranged from 10 to 50 mg/kg/day, and the mean gabapentin serum concentration correlating with seizure control was 3.7 mcg/ml. Hyperactivity, irritability, and agitation, in 15 (46%) children with mental retardation and attention deficits, were the major side effects. Mild behavior changes not requiring drug withdrawal, including impulsivity. irritability, and hyperactivity, were reported in 11 additional children. Personality was improved in 3 children. 
COMMENT. Gabapentin may be an effective adjunctive medication in children with refractory partial seizures. Behavioral side effects were reversible when the drug was discontinued and were most prominent in the mentally retarded.