Vigabatrin in Childhood Epilepsy: A 5-Year Follow-Up Study

Abstract

In an retrospective uncontrolled long-term study in 30 children with intractable epilepsy, it was found that treatment with vigabatrin resulted in a seizure reduction of more than 50% at 1-year follow-up in 40% of the children. The responders were all children with partial seizures. Side effects were mild and did not lead to discontinuation of the drug. Increased numbers of seizures were seen in three cases. A moderate weight increase was seen in 27% of the children. At 5-year follow-up 7 children (23%) still maintained a seizure reduction of more than 50%. Trials of monotherapy in three seizure-free patients were unsuccessful. No further side effects were observed. A study of evoked potentials in 12 children showed no alteration in latency and amplitudes of VEP following treatment with vigabatrin. Our results show that in children vigabatrin seems to have a stable effect even though a few children may experience a breakthrough of seizures. The presented results together with previous reports on MRI-scans seem to indicate that even in children with a still maturing CNS vigabatrin is a safe drug.

Retinal nerve fibre layer characteristics with vigabatrin-associated visual field loss—could scanning laser polarimetry aid diagnosis?

“…Vigabatrin (Sabril, Hoechst Marion Roussel/ Aventis Ltd) is an inhibitor of g-aminobutyric (GABA) transaminase and has been used as an effective second-line medication in the treatment of infantile seizures, 1 seizures associated with tuberous sclerosis, 2 and epilepsy of partial onset. 3 Its action is to potentiate the effect of GABAFan inhibitory neurotransmitterFby preventing its inactivation.…”

Characteristic retinal atrophy with secondary “inverse” optic atrophy identifies vigabatrin toxicity in children

“…Vigabatrin (Sabril, Aventis Pharma, Laval, Canada) is an effective and popular γ-aminobutyric acid-ergic (GABA-ergic) anticonvulsant used in the management of infantile spasm (West syndrome), 1,2 in seizures associated with tuberous sclerosis, 3 and in partial seizures of adults as adjunctive therapy. 4 It acts by irreversible inhibition of GABA transaminase with the resultant accumulation of the inhibitory neurotransmitter GABA in the brain with even higher concentrations in the retina.…”

The Safety and Tolerability of Newer Antiepileptic Drugs in Children and Adolescents

“…[296,298,300,303,305,307,308,359,360] Weight gain is attributed to increased appetite in several studies. [300,303,308] Fatal hepatotoxicity was reported in a 3-yearold with a history of prematurity and perinatal cerebral haemorrhage treated with vigabatrin and phenobarbital for 9 months.…”