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Irish Child Health Database - Peer Reviewed Papers

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  • The use of lamotrigine, vigabatrin and gabapentin as add-on therapy in intractable epilepsy of childhood

    Published in:

    Seizure, Vol: 14, Page: 112-6

    Publication Date:

    March 2005

    Aims & Objectives:

    This study examines the efficacy, long-term survival and adverse event profile of three anti-epiletic agents used as add-on therapy in children with refractory epilepsy over a 10-year period

    Abstract:

    PURPOSE: Lamotrigine (LTG), vigabatrin (VGB) and gabapentin (GBP) are three anti-epileptic drugs (AEDs) used in the treatment of children with epilepsy for which long-term retention rates are not currently well known. This study examines the efficacy, long-term survival and adverse event profile of these three agents used as add-on therapy in children with refractory epilepsy over a 10-year period. METHODS: Three separate audits were conducted between February 1996 and September 2000. All children studied had epilepsy refractory to other AEDs. Efficacy was confirmed if a patient became seizure free or achieved >50% reduction in seizure frequency for 6 months or more after starting therapy. Adverse events and patient survival for each drug were recorded at the end of the study period. RESULTS: Between September 1990 and February 1996, 132 children received LTG, 80 VGB and 39 GBP. At the 10-year follow-up audit, 33% of the children on LTG had a sustained beneficial effect on their seizure frequency in contrast to 19% for VGB and 15% for GBP. No significant difference in efficacy was found in children with partial seizures. Children with epileptic encephalopathy (EE) including myoclonic-astatic epilepsy and Lennox-Gastaut Syndrome (LGS) achieved a more favorable response to LTG. The main reasons for drug withdrawal were lack of efficacy for VGB, apparent worsening of seizures for GBP and the development of a rash for LTG. CONCLUSIONS: Lamotrigine is a useful add-on therapy in treating children with epilepsy. It has a low adverse event profile and a sustained beneficial effect in children with intractable epilepsy.

    Authors:

    D. G. McDonald; Y. Najam; M. B. Keegan; M. Whooley; D. Madden; J. B. McMenamin

    Study Type:

    Study Papers » Audit » Descriptive Studies - Measuring aspects of effectiveness

    Categories:

    anti-epiletic agents for refractory epilepsy

    International Classification:

    Diseases of the nervous system - Episodic and paroxysmal disorders - epilepsy

    Keywords:


    Geography:

    Republic of Ireland (Children's seizure Disorder Clinic Crumlin Hospital for Dublin)