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The use of topical steroids should be strictly confined to the parameters framed by medical experts: Apply topical steroids in small quantities only over the areas that are affected. Some of the anticonvulsants are available over the counter, but it is strongly recommended that this option should be avoided. The flurothyl ether baths provided by German Bayer Pharma group are recommended for individual paediatric patients. These are the only FDA-approved baths for epilepsy, but studies show that they are inferior to taking individual TCAs, if a combination of three or more TCAs is preferred. In addition to topical flurothyl ether baths, medically supervised florbetaben baths with appropriate ventilators should be performed by experienced paediatric anaesthetists. Linaclotide tablets should only be given to patients who cannot be managed well with oral anticonvulsants (see: Summary of Uses ). Ximelagimod tablets can also be given to particularly severe epilepsy patients at high doses over a six to eight month period in a blinded study of 0·5 mg on two different occasions with venlafaxine and topiramate. If intended for the Dravet syndrome, a guideline dosage of 1,000 mg of Ximelagimod was not met.25 Bextra and birtulizumab were used in one study of 18 children with epilepsy and 55 children without.9 Fenofibrate was tried as add-on to dipyridamole for 18 children and 90 children without epilepsy.24 Malarone (a drug used to treat malaria) was given to five children with intractable refractory epilepsy over two years. Some of the medicines have poor bioavailability and can be applied to the entire body, which can compromise the efficacy of their antiepileptic effect and the effectiveness of their dermal anaesthesia. Patients with inappropriate pharmacotherapy strategies can have poor clinical outcomes. Combined oral antiepileptic therapy (compared with existing anticonvulsant drugs) has been shown to improve seizure frequency and response to treatment. However, due to the resultant increased risk of drug-related weight gain, an initial phase III trial in children with SLE was only undertaken in centres with large numbers of paediatric SLE casesSimilar articles: