Long-term Antiepileptic Efficacy of Vigabatrin in Drug-Refractory Epilepsy in Mentally Retarded Patients

Lee

et al. 2010

E&S

Purpose: To investigate the effectiveness and tolerability of topiramate (TPM) in treating children with CNS anomalies and intractable epilepsy. Methods: We retrospectively searched the patient database in National Taiwan University Hospital for candidate children (younger than 18 years of age) with epilepsy and CNS anomalies from December 2002 to February 2004. The effectiveness and possible side effects of TPM were evaluated by questionnaire. Results: Twenty-two children (9 males, 13 females) aged from five months to fourteen years were enrolled in the present study. Underlying CNS anomalies were proliferation disorders (n=10), migration/organization disorders (n=10), and neurocutaneous syndromes (n=2). Types of epilepsy at TPM add-on were symptomatic partial epilepsy (n=11), infantile spasms (n=7), and Lennox-Gastaut syndrome (n=4). During the follow-up periods of six to 30 months, eight patients (36%) had more than 50% reduction of seizures and four patients (18%) were seizure-free. The average dosages

Section: Discussionsupporting

confidence: 47%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical experience with open-label topiramate use in epileptic children with CNS anomalies

Lee

et al. 2010

E&S

“…Improved seizure control also has been claimed with LTG in observational studies (12)(13)(14). VGB reduced seizures by Ն50% in 36 patients with learning disability with a gradual reduction to 22% of patients after 5 years' follow-up (15). This drug is more often associated with behavioural problems than are LTG and GBP in this population (16).…”

Section: Discussionmentioning

confidence: 66%

Topiramate in Patients with Learning Disability and Refractory Epilepsy

et al. 2002

Summary:Purpose: Management of seizures in learning disabled people is challenging. This prospective study explored the efficacy and tolerability of adjunctive topiramate (TPM) in patients with learning disability and refractory epilepsy attending a single centre.Methods: Sixty-four patients (36 men, 28 women, aged 16-65 years) were begun on adjunctive TPM after a 3-month prospective baseline on unchanged medication. Efficacy end points were reached when a consistent response was achieved over a 6-month period at optimal TPM dosing. These were seizure freedom or Ն50% seizure reduction (responder). Appetite, behaviour, alertness, and sleep were assessed by caregivers throughout the study.Results: Sixteen (25%) patients became seizure free with adjunctive TPM. There were 29 (45%) responders. A further 10 (16%) patients experiencing a more modest improvement in seizure control continued on treatment at the behest of their family and/or caregivers. TPM was discontinued in the remaining nine (14%) patients, mainly because of side effects. Final TPM doses and plasma concentrations varied widely among the efficacy outcome groups. Many patients responding well to adjunctive TPM did so on Յ200 mg daily. Mean carer scores did not worsen with TPM therapy. Conclusions: TPM was effective as add-on therapy in learning-disabled people with difficult-to-control epilepsy. Seizure freedom is a realistic goal in this population.

“…247 Psychosis was the reason for withdrawal in a follow-up study of patients described as mentally retarded, which also reported that psychiatric AEs often appeared during the second year of treatment (up to 3 g/day VGB). 248 Psychosis was the reason for withdrawal of one patient after 1 year in an open-label extension study in which two more patients experienced dose-related psychotic symptoms. The dose range reached 5 g/day.…”

mentioning

confidence: 99%

Clinical effectiveness, tolerability and cost-effectiveness of newer drugs for epilepsy in adults: a systematic review and economic evaluation

Wilby¹,

Kainth²,

Hawkins³

et al. 2005

Health Technol Assess

199

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