Antonio Gil‑Nagel, Leopoldo Pérez de la Isla, Elena Sanz Pascual, Enrique J. Balbacid Domingo, Juan J. García Peñas
Ruber Internacional Hospital. San Carlos Clinical Hospital. La Paz Children’s Hospital and La Paz University Hospital. Universidad Europea de Madrid. Spanish Society of Cardiology. Niño Jesús University Children’s Hospital.
Spain
Neurology and Therapy
Neurol Ther 2026;
DOI: 10.1007/s40120-026-00930-2
Abstract
Introduction: Fenfluramine (FFA) is approved as an adjunctive treatment for epileptic seizures associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients aged 2 years and older. Owing to its pharmacological characteristics and history of cardiovascular adverse effects, specific cardiological monitoring is required throughout the course of treatment.
Methods: A set of recommendations for FFA was developed by a multidisciplinary panel comprising specialists in neurology/paediatric neurology, epilepsy, and cardiology (both adult and paediatric). The process involved a literature review, methodological design, working group sessions, and preparation of recommendations structured around three key phases: before treatment, during treatment, and after treatment discontinuation.
Results: An expert-led algorithm for the use of FFA was developed, helping to establish a common language that promotes a better understanding between cardiologists and neurologists/paediatric neurologists, facilitating the prevention and early management of potential cardiovascular events.
Conclusion: The management of FFA treatment should be holistic, with coordinated follow-up involving neurologists, paediatric neurologists, and cardiologists. Implementing a structured, expert-based protocol will help enhance treatment safety and optimize clinical outcomes for patients with developmental and epileptic encephalopathies.
Category
Class I. Drug-induced and Toxin-induced Pulmonary Hypertension
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes