The efficacy of felbamate as add-on therapy to valproic acid in the Lennox–Gastaut syndrome

Siegel, Heidi E.; Kelley, Kathleen; Stertz, Barbara; Reeves-Tyer, Patricia; Flamini, Robert; Malow, Beth A.; Gaillard, William D.; Ko, David; Theodore, William H.

doi:10.1016/s0920-1211(98)00119-3

Cited by 42 publications

(16 citation statements)

References 15 publications

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“…This AED was the first to be approved for adjunctive therapy in LGS after a double-blind, randomized, placebo-controlled study showed a significant effect on “major” seizures (FBM study group 1993). Open studies (Dodson et al 1993; Jensen 1994; Gay et al 1995; Avanzini et al 1996; Eriksson et al 1998) and another double-blind study (Siegel et al 1999) confirmed these initial results.…”

Section: Chronic Medical Treatmentmentioning

confidence: 57%

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Rijckevorsel¹

2008

NDT

118

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Lennox-Gastaut syndrome (LGS) is a rare, age-related syndrome, characterized by multiple seizure types, a specifi c electro-encephalographic pattern, and mental regression. However, published data on the etiology, evolution, and therapeutic approach of LGS are contradictory, partly because the precise defi nition of LGS used in the literature varies. In the most recent classifi cation, LGS belongs to the epileptic encephalopathies and is highly refractory to all antiepileptic drugs. Numerous treatments, medical and non-medical, have been proposed and results mostly from open studies or case series have been published. Sometimes, patients with LGS are included in a more global group of patients with refractory epilepsy. Only 6 randomized double-blind controlled trials of medical treatments, which included patients with LGS, have been published. Overall, treatment is rarely effective and the fi nal prognosis remains poor in spite of new therapeutic strategies. Co-morbidities need specifi c treatment. This paper summarizes the defi nition, diagnosis and therapeutic approach to LGS, including not only recognized antiepileptic drugs, but also "off label" medications, immune therapy, diet, surgery and some perspectives for the future.

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Section: Chronic Medical Treatmentmentioning

confidence: 57%

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Rijckevorsel¹

2008

NDT

118

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“…Although several other studies have demonstrated felbamate effective in LGS,38,40 clinicians remain judicious with its use 24,25. Postmarketing analysis has revealed felbamate may cause aplastic anemia (1 in 5,000–10,000) and hepatic failure (1 in 26,000 to 34,000) 11,41.…”

Section: Medical Therapies – Available Treatmentsmentioning

confidence: 99%

Treatment-resistant Lennox-Gastaut syndrome: therapeutic trends, challenges and future directions

Ostendorf

2017

NDT

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Lennox-Gastaut syndrome is a severe, childhood-onset electroclinical syndrome comprised of multiple seizure types, intellectual and behavioral disturbances and characteristic findings on electroencephalogram of slow spike and wave complexes and paroxysmal fast frequency activity. Profound morbidity often accompanies a common and severe seizure type, the drop attack. Seizures often remain refractory, or initial treatment efficacy fades. Few individuals are seizure free despite the development of multiple generations of antiseizure medications over decades and high-level evidence on several choices. Approved medications such as lamotrigine, topiramate, rufinamide, felbamate and clobazam have demonstrated efficacy in reducing seizure burden. Cannabidiol has emerged as a promising investigational therapy with vast social interest yet lacks a standard, approved formulation. Palliative surgical procedures, such as vagal nerve stimulation and corpus callosotomy may provide reduction in total seizures and drop attacks. Emerging evidence suggests that complete callosotomy provides greater improvement in seizures without additional side effects. Etiologies such as dysplasia or hypothalamic hamartoma may be amenable for focal resection and thus offer potential to reverse this devastating epileptic encephalopathy.

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“…149 Felbamate significantly reduced all seizures compared with placebo (-19% vs +4%; p=0.002), including drop attacks and GTCS. 120,149,150,152,157 The effect on atypical absences was not reported. As felbamate can cause fatal side effects it is now only available for specific cases.…”

Section: Newer Aedsmentioning

confidence: 99%

Epileptic encephalopathies in infancy and early childhood

Panayiotopoulos¹

2010

A Clinical Guide to Epileptic Syndromes and Their Treatment

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ten Clinical note Reversible causes for epileptic spasmsDrugs such as theophylline 57 or anti-allergic agents of hista mine H 1 -receptor antagonists, particularly ketotifen, 58 may induce epileptic spasms and hypsar rhythmia that are entirely reversible upon drug withdrawal.Pyridoxine dependency, which is treatable, can in rare instances present with epileptic spasms. This is most likely when other seizure types have occurred before the onset of spasms. 46 AetiologyThe aetiology is multiple and diverse. Aetiologically, West syndrome is classified, in order of preva lence, as symptomatic (about 80% of all) due to discernible organic insults, and cryptogenic or idiopathic

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The efficacy of felbamate as add-on therapy to valproic acid in the Lennox–Gastaut syndrome

Cited by 42 publications

References 15 publications

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Treatment-resistant Lennox-Gastaut syndrome: therapeutic trends, challenges and future directions

Epileptic encephalopathies in infancy and early childhood

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