Lamotrigine-induced seizure aggravation and negative myoclonus in idiopathic rolandic epilepsy

Cerminara, Caterina; Montanaro, Maria; Curatolo, Paolo; Seri, Stefano

doi:10.1212/01.wnl.0000130195.62670.a6

Cited by 58 publications

(23 citation statements)

References 8 publications

(4 reference statements)

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“…There are reports of children with focal symptomatic epilepsies or idiopathic focal epilepsies in which classic antiepileptic drugs, such as carbamazepine, oxcarbazepine, phenobarbital, or phenytoin may induce the appearance of ESES; these should be avoided (Caraballo et al., 1989; Guerrini et al., 1995; Fejerman et al., 2000). Valproic acid, lamotrigine, topiramate, and levetiracetam have also been involved in sporadic cases, but more data are necessary (Prats et al., 1998; Catania et al., 1999; Montenegro & Guerreiro, 2002; Cerminara et al., 2004; Caraballo et al., 2010). To our knowledge, this phenomenon of drugs aggravating EEG abnormalities has not been mentioned in patients using sulthiame.…”

Section: Discussionmentioning

confidence: 99%

Sulthiame add‐on therapy in children with focal epilepsies associated with encephalopathy related to electrical status epilepticus during slow sleep (ESES)

et al. 2012

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Summary Purpose: In children with symptomatic or idiopathic focal epilepsies, their disease may evolve into an epileptic encephalopathy related to continuous spike and wave during slow sleep (CSWS) or electrical status epilepticus during slow sleep (ESES). ESES syndrome implies serious risks of neuropsychologic impairment, and its treatment has frequently been disappointing. The aim of this study is to present our experience using sulthiame as add‐on treatment in 53 patients with ESES syndrome that was refractory to other antiepileptic drugs (AEDs). Methods: Neurologic examinations, cerebral magnetic resonance imaging (MRI), and repeated prolonged sleep electroencephalography (EEG) studies were performed in all cases. Data about school achievements and or neuropsychological evaluations were obtained repeatedly during the follow‐up of 1.5–16 years. Sulthiame was added in doses ranging between 5 and 30 mg/kg/day. Key Findings: Since add‐on of sulthiame, 10 of 28 patients in the symptomatic group became seizure free: 4 patients with normal EEG studies and 6 with residual spikes. Nine of 28 patients showed a significant reduction in number of seizures and presented spikes but no ESES on EEG. The other nine cases showed neither clinical nor EEG improvement. A striking result was that 3 of 11 children with unilateral polymicrogyria and ESES syndrome became seizure free, and in another six a significant improvement in frequency of seizures and in EEG abnormalities seemed to be related to the add‐on of sulthiame. Twenty‐one of the 25 patients in the idiopathic group became seizure free and without ESES in <3 months after add on of sulthiame. In two of the patients the changes were seen in a few days. Significance: We understand that sulthiame may be effective as add‐on treatment in children with ESES syndrome.

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Section: Discussionmentioning

confidence: 99%

Sulthiame add‐on therapy in children with focal epilepsies associated with encephalopathy related to electrical status epilepticus during slow sleep (ESES)

et al. 2012

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“…Seizure aggravation as a consequence of prescribing an inappropriate AED for the particular seizure type or because of a paradoxical exacerbation of seizures should be followed by prompt review of treatment [8][9][10][11][12][13][14][15][16][17][18] (table II). Once identified, the most appropriate AED, starting with low doses, slow titration, adequate posology choice and individualization of the minimal effective maintenance doses, may greatly improve safety and tolerability.…”

Section: Safety and Tolerability: General Considerationsmentioning

confidence: 99%

Safety and Tolerability of Antiepileptic Drug Treatment in Children with Epilepsy

et al. 2012

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“…In our prospective series of 38 children, antiepileptic treatment with a single drug had been offered in about a third of them, and only three children (8%) needed combined drug treatment (unpublished data); most fared well on monotherapy with carbamazepine (but not only) although one suffered paradoxical worsening triggered by this agent (Kikumoto et al, 2006). Such reactions have been well documented also in children with benign rolandic epilepsy, therefore, carbamazepine (Nanba and Maegaki, 1999; Parmeggiani et al, 2004) and possibly lamotrigine (Catania et al, 1999; Cerminara et al, 2004), which has also caused a paradoxical reaction in children with rolandic epilepsy should be used with some caution.…”

Section: Outcome and Managementmentioning

confidence: 99%

Panayiotopoulos Syndrome: An Important Electroclinical Example of Benign Childhood System Epilepsy

Koutroumanidis

2007

Epilepsia

112

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Summary:As a result of the converging evidence from multiple large independent studies, Panayiotopoulos syndrome (PS) is now formally recognized as a distinct clinical entity within the spectrum of benign focal epilepsies of childhood. Clinically, PS is manifested by predominantly autonomic seizures and electrographically with multifocal interictal spikes, while the few published ictal recordings have documented onsets of variable lobar topography. These typical electroclinical features do not allow straightforward assignment to a distinctive cortical area, rendering the term "focal"-as we currently understand it-problematic. This is a critical review of the clinical and EEG features of PS, focusing on those characteristics that may shed some light on its so far elusive pathophysiology. We also explore its electroclinical similarities to other idiopathic "focal" epilepsies and its differences to symptomatic focal epilepsies that may also manifest with autonomic ictal symptoms and signs. This methodology allows the formation of a rational hypothesis on the pathophysiology of PS that seems to be emerging as a good model for the so-called "system" (nonsymptomatic) epilepsies, with potentially important taxonomic implications.

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Lamotrigine-induced seizure aggravation and negative myoclonus in idiopathic rolandic epilepsy

Cited by 58 publications

References 8 publications

Sulthiame add‐on therapy in children with focal epilepsies associated with encephalopathy related to electrical status epilepticus during slow sleep (ESES)

Sulthiame add‐on therapy in children with focal epilepsies associated with encephalopathy related to electrical status epilepticus during slow sleep (ESES)

Safety and Tolerability of Antiepileptic Drug Treatment in Children with Epilepsy

Panayiotopoulos Syndrome: An Important Electroclinical Example of Benign Childhood System Epilepsy

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