Dravet – CBD Approved, NaChannel Blockers CI — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersDravet – CBD Approved, NaChannel Blockers CISCE Neurology

Dravet syndrome (SCN1A mutation) — which AED is specifically approved? Which are contraindicated?

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Correct answer: A — Cannabidiol (Epidyolex) is approved (NICE TA614). Sodium channel blockers (CBZ, PHT, LTG, OXC) are CONTRAINDICATED as they worsen seizures in SCN1A loss-of-function

Dravet: SCN1A loss-of-function. Further sodium channel blockade worsens seizures. First-line: valproate, clobazam, stiripentol, fenfluramine. Cannabidiol approved as adjunct. A: CBZ worsens Dravet. C: PHT worsens Dravet. D: Gabapentin ineffective. E: Vigabatrin for TSC spasms.

Reference: NICE TA614; BNF