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The effect of tiagabine on spasticity in children with intractable epilepsy: a pilot study
1Division of Pediatric Neurology, Medical University of South Carolina, Charleston 29425, USA.
Insights
Tiagabine, an antiepileptic drug, showed potential in relieving spasticity and reducing seizures in children with spastic quadriplegia. Further studies are needed to confirm these promising findings for neurodevelopmental disorders.
Area of Science:
- Neuroscience
- Pharmacology
- Pediatrics
Background:
- Tiagabine is a gamma-aminobutyric acid-uptake inhibitor initially developed for epilepsy.
- Preliminary evidence suggests potential efficacy in treating spasticity.
Purpose of the Study:
- To assess the efficacy of tiagabine in improving motor function and reducing seizure frequency in children with spastic quadriplegia and epilepsy.
Main Methods:
- Pilot study involving 14 children with spastic quadriplegia and refractory epilepsy.
- Tiagabine dosage was titrated based on seizure control and adverse effects.
- Motor function assessed using the modified Ashworth scale; seizure frequency was also monitored.
Main Results:
- Significant improvement in motor function (approx. 50% increase) including tone, strength, and coordination.
- Observed reduction in seizure frequency ranging from 50% to 74%.
- Commonly reported benefits included improved limb function and reduced ataxia.
Conclusions:
- Tiagabine demonstrated potential as a treatment for spasticity and epilepsy in children with neurodevelopmental disorders.
- Further randomized, double-blind controlled studies are necessary to validate these findings.
Abstract:
Preliminary pharmacologic evidence suggests that tiagabine, a new presynaptic gamma-aminobutyric acid-uptake inhibitor developed as an antiepileptic drug, may also relieve spasticity. This pilot study assessed the drug's efficacy in 14 children with congenital or acquired spastic quadriplegia and concomitant intractable epilepsy refractory to treatment with multiple antiepileptic drugs. The primary outcome variable was change in motor function; the secondary outcome was change in seizure frequency. Tiagabine was initiated at 0.1-0.2 mg/kg/day and then gradually titrated upward until seizures ceased, adverse effects supervened, or the maximum dose of 1.1 mg/kg/day was reached. When a modified Ashworth scale was used to assess motor function, a mean improvement of approximately 50% was observed. Common findings included improved tone, strength, coordination, range of motion, and relaxation of extremities, with less ataxia and wobbling. Mean reduction in seizure frequency was 50-74%. Randomized, double-blind controlled studies are needed to confirm the suggested efficacy of tiagabine in relieving chronic spasticity in children with neurodevelopmental disorders.