Frontolimbic Dysfunction as a Pathogenetic Mechanism of Autism: Localization of Paroxysmal Abnormality in the Magnetoencephalogram.

The medical management of epilepsy in the multi‐handicapped patient requires careful evaluation, classification, and pharmacologic treatment. It is estimated that 20–40% of patients with mental retardation and cerebral palsy have epilepsy. This review reports the clinical trial data and personal experience related to the use of newer AEDs in the chronic management of epilepsy syndromes in children and adults, as well as information available on the treatment of seizures in individuals with mental retardation and associated handicaps. Furthermore, clusters of seizures, prolonged seizures and status epilepticus are more commonly seen in the multiply handicapped and mentally retarded population and require special attention. The new antiepileptic drugs felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, vigabatrin and zonisamide show specific advantage in some multiply handicapped patients, be it for seizure control or medication tolerance. Furthermore, new modalities of treatment for prolonged seizures allow better efficacy both outside of hospital and within hospital facilities. The treatment of epilepsy in multi‐handicapped and retarded adults and children has significantly advanced in the past few years, and much of this improvement can be attributed to improved knowledge and monitoring of new antiepileptic drugs. Conventional anticonvulsants remain first line therapy for most clinicians, but newer AEDs must broaden the therapeutic option and do allow improved therapy for some multiply handicapped patients. MRDD Research Reviews 2000;6:309–323. © 2000 Wiley‐Liss, Inc.

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Treatment of epilepsy in the multiply handicapped

Pellock

Morton

2000

Ment. Retard. Dev. Disabil. Res. Rev.

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Lamotrigine in childhood epilepsies

Dreifuss

1997

Seminars in Pediatric Neurology

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The use of tiagabine in pediatric spasticity management

Chu¹,

Sala²

2006

Dev Med Child Neurol

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Tiagabine, developed as an anti-epileptic medication, has the potential to reduce spasticity. The purpose of the present study was to assess the effectiveness of tiagabine in decreasing spasticity and improving the functional abilities of children with spastic cerebral palsy (CP). Nine children (seven females, two males) with CP (six spastic quadriplegia, three moderate to severe spastic diplegia) were treated with tiagabine for a mean of 7.2 months. Median age was 4y 5mo (range 3y 2mo-10y). All children were non-ambulatory. According to the Gross Motor Function Classification System, six were Level IV and three were Level V. Only one child showed a median decrease >or=1.0 grade on the modified Ashworth scale in upper extremities, lower extremities, and overall. Another child had significant improvement in the Pediatric Evaluation of Disability Inventory Self-care score and improved feeding. None of the participants was found to have a significant improvement in motor function or a decrease in the number of motions (passive range of motion and muscle length test) that were limited. Reduction of nocturnal awakenings from painful spasms was reported in one child. Eight of the nine children experienced adverse side-effects during treatment. Although tiagabine was not found to be effective in decreasing children's spasticity or improving their function, its potential use in the relief of painful spasms associated with neurological conditions in the pediatric population warrants further investigation.

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Frontolimbic Dysfunction as a Pathogenetic Mechanism of Autism: Localization of Paroxysmal Abnormality in the Magnetoencephalogram.

Cited by 14 publications

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Treatment of epilepsy in the multiply handicapped

Treatment of epilepsy in the multiply handicapped

Lamotrigine in childhood epilepsies

The use of tiagabine in pediatric spasticity management

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