There are numerous potential factors that may affect growth in children with epilepsy, and these must be evaluated in any child with appetite and weight concerns. Antiseizure medications (ASMs) have potential adverse effects, and many may affect appetite, thus impacting normal growth and weight gain. The aim of this review is to focus on the impact of both epilepsy and ASMs on appetite and weight in children. We systematically reviewed studies using Medline assessing the impact of ASMs on appetite and weight in children. Eligible studies included randomized controlled trials and open-label studies (open-label extension and interventional) that targeted or included the pediatric population (0-18 years of age). Each study was classified using the American Academy of Neurology (AAN) Classification of Evidence for Therapeutic Studies, and the level of evidence for impact on appetite and weight in children was graded. ASMs associated with decreased appetite and/or weight loss include fenfluramine, topiramate, zonisamide, felbamate, rufinamide, stiripentol, cannabidiol, brivaracetam and ethosuximide; ASMs with minimal impact on weight and appetite in children include oxcarbazepine, eslicarbazepine, lamotrigine, levetiracetam, lacosamide, carbamazepine, vigabatrin and clobazam. The ASM most robustly associated with increased appetite and/or weight gain is valproic acid; however, both pregabalin and perampanel may also lead to modest weight gain or increased appetite in children. Certain ASMs may impact both appetite and weight, which may lead to increased morbidity of the underlying disease and impaired adherence to the treatment regimen.

中文翻译：

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抗癫痫药物对儿童食欲和体重的影响。

有许多可能影响癫痫儿童生长的潜在因素，必须对任何有食欲和体重问题的儿童进行评估。抗癫痫药物 (ASM) 具有潜在的副作用，其中许多可能会影响食欲，从而影响正常生长和体重增加。本综述的目的是关注癫痫和 ASM 对儿童食欲和体重的影响。我们系统地回顾了使用 Medline 评估 ASM 对儿童食欲和体重影响的研究。符合条件的研究包括针对或包括儿科人群（0-18 岁）的随机对照试验和开放标签研究（开放标签扩展和介入）。每项研究均使用美国神经病学学会 (AAN) 治疗研究证据分类，并对影响儿童食欲和体重的证据水平进行了分级。与食欲下降和/或体重减轻相关的 ASM 包括芬氟拉明、托吡酯、唑尼沙胺、非尔氨酯、卢非酰胺、司替戊醇、大麻二酚、布瓦西坦和乙琥胺；对儿童体重和食欲影响最小的 ASM 包括奥卡西平、艾司利卡西平、拉莫三嗪、左乙拉西坦、拉考沙胺、卡马西平、氨己烯酸和氯巴占。与食欲增加和/或体重增加最密切相关的 ASM 是丙戊酸；然而，普瑞巴林和吡仑帕奈也可能导致儿童体重适度增加或食欲增加。某些 ASM 可能会影响食欲和体重，这可能导致潜在疾病的发病率增加和对治疗方案的依从性受损。