Lamotrigine in childhood epilepsies

Dreifuss, Fritz E.

doi:10.1016/s1071-9091(97)80005-8

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…A logistic regression proportional odds model was fit to the data to explore the combination of variables that best explained the classification of subjects as a (1) Nonresponder, (2) 50–99% Seizure reduction responder, and (3) >99% Seizure reduction responder (seizure‐free responder). The variables used for the model included both qualitative nominal variables Gender (Male, Female), Infantile Spasms (Yes, No), Partial Seizures (Yes, No), and quantitative variables (Age at Diagnosis, Age at Onset, and Duration of Lamictal).…”

Section: Methodsmentioning

confidence: 99%

“…Its mechanism of action is thought to involve blockade of voltage‐sensitive sodium channels, and thereby inhibition of release of excitatory neurotransmitters. It appears to have less potential for cognitive slowing/impairment than many of the traditional AEDs (1) Anecdotally, LTG has been reported to be beneficial for self‐injurious and autistic behaviors, either with or without concurrent epilepsy. It also has been used for purely psychiatric indications, for example, as a mood‐stabilizing agent (2).…”

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confidence: 99%

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Lamotrigine Therapy of Epilepsy in Tuberous Sclerosis

et al. 2001

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Summary:Purpose: Lamotrigine (LTG), a newer antiepileptic drug (AED), has activity against both partial-onset and generalized seizures. Its reported benefits for behavior, and its effectiveness in Lennox-Gastaut syndrome and other forms of refractory epilepsy, make it a logical choice for treatment of epilepsy in tuberous sclerosis complex (TSC). We present our experience with LTG therapy of epilepsy in 57 patients with TSC.Methods: Patients fulfilled the diagnostic criteria for clinically definite TSC. LTG was initiated and increased until improvement in seizure frequency was noted, intolerable side effects occurred, or maximal doses were reached. Seizure frequency and behavioral changes were recorded during LTG therapy and compared with those prior to the introduction of LTG.Results: Twenty-four (42%) were seizure free, and 21 (37%) had a >50% reduction in seizure frequency. Eighteen (32%) had subjectively improved behavior and/or alertness with daily activities. Thirty-eight (67%) had no change in this regard, whereas one (2%) became worse. Responders were more likely to not have a history of infantile spasms, and to have experienced only partial seizures (p < 0.05). Otherwise no phenotypic correlations with response were apparent.Conclusions: Among patients with TSC and epilepsy, LTG was effective and well tolerated, including as initial monotherapy. Improved alertness and behavior were apparent in many patients. The incidence of side effects is similar to that reported for other pediatric populations with symptomatic partial epilepsy. The usefulness of LTG in TSC may relate to an underlying defect of glutamatergic neurotransmission in partial epilepsy.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Lamotrigine Therapy of Epilepsy in Tuberous Sclerosis

et al. 2001

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“…Valproate (VPA) is effective against all of these seizure types and consequently is the drug of choice. Lamotrigine (LTG) is another broad-spectrum drug that treats absence and convulsive seizures and is often considered after VPA fails (2)(3)(4)(5)(6). Topiramate (TPM), on the other hand, although a very potent broad-spectrum drug that is effective against a wide range of seizures in children, appears to have weak antiabsence action (7)(8)(9)(10)(11).…”

Section: Juvenile Absence Epilepsymentioning

confidence: 99%

Special Needs of the Adolescent with Epilepsy

Nordli¹

2001

Epilepsia

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Adjustment to the inherent changes of adolescence is a challenge for many children, even healthy ones. Epilepsy may make successful adjustment even more difficult by disrupting self-control, adversely affecting the ability to conform to one's peers, and interfering with independence. Epilepsy and its treatment may affect education, employment, use of alcohol and illicit drugs, sexual activity, and pregnancy. These issues, in turn, may affect seizure control. Matching the medicine to the patient is particularly important in teenagers, a group of patients with special needs. Common seizure syndromes presenting in adolescence are briefly reviewed and used to illustrate key issues that may arise in the selection of an antiepileptic medication (AED). Compliance, interaction with other medications including oral contraceptive medications, cosmetic effects, teratogenicity, and impact on behavior are all factors to be considered. Newer medications may have some advantages over older compounds in this regard, and evidence of their utility is reviewed in the specific context of the epilepsy syndromes. In addition to prescribing medication, other important parts of the therapeutic management involve education, counseling, support, and advocacy. To identify issues and to provide appropriate counseling, it is beneficial to devote some of the office visit to an independent interaction with the patient, apart from the parents. One study questionnaire indicated that nurse specialists may be particularly valuable in supporting and meeting the needs of patients in this age group. Some centers have developed elegant methods of helping the patient make the transition from child neurology to adult neurology.

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Special Needs of the Adolescent with Epilepsy

Nordli

2001

Epilepsia

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Summary: Adjustment to the inherent changes of adolescence is a challenge for many children, even healthy ones. Epilepsy may make successful adjustment even more difficult by disrupting self‐control, adversely affecting the ability to conform to one's peers, and interfering with independence. Epilepsy and its treatment may affect education, employment, use of alcohol and illicit drugs, sexual activity, and pregnancy. These issues, in turn, may affect seizure control. Matching the medicine to the patient is particularly important in teenagers, a group of patients with special needs. Common seizure syndromes presenting in adolescence are briefly reviewed and used to illustrate key issues that may arise in the selection of an antiepileptic medication (AED). Compliance, interaction with other medications including oral contraceptive medications, cosmetic effects, teratogenicity, and impact on behavior are all factors to be considered. Newer medications may have some advantages over older compounds in this regard, and evidence of their utility is reviewed in the specific context of the epilepsy syndromes. In addition to prescribing medication, other important parts of the therapeutic management involve education, counseling, support, and advocacy. To identify issues and to provide appropriate counseling, it is beneficial to devote some of the office visit to an independent interaction with the patient, apart from the parents. One study questionnaire indicated that nurse specialists may be particularly valuable in supporting and meeting the needs of patients in this age group. Some centers have developed elegant methods of helping the patient make the transition from child neurology to adult neurology.

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Lamotrigine in childhood epilepsies

Cited by 5 publications

References 30 publications

Lamotrigine Therapy of Epilepsy in Tuberous Sclerosis

Lamotrigine Therapy of Epilepsy in Tuberous Sclerosis

Special Needs of the Adolescent with Epilepsy

Special Needs of the Adolescent with Epilepsy

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