[The use of lamotrigine monotherapy in children with newly diagnosed partial epilepsy]
E Sołowiej1, W Sobaniec, A Kozik
1Klinika Neurologii Dzieciecej AM w Białymstoku.
Insights
Lamotrigine monotherapy effectively treated newly diagnosed pediatric epilepsy, with 63% experiencing reduced seizures and 10 becoming seizure-free. This epilepsy treatment showed good tolerability in children.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Lamotrigine is established for refractory epilepsy.
- Limited data exists on lamotrigine monotherapy in pediatric epilepsy.
Purpose of the Study:
- Assess lamotrigine monotherapy's efficacy and tolerability.
- Evaluate treatment in newly diagnosed pediatric partial epilepsy.
Main Methods:
- 19 children (3-16 years) with partial epilepsy received lamotrigine.
- Dosage: 3.87 +/- 1.02 mg/kg/day for 24 weeks.
- Assessed seizure frequency, EEG, and adverse events.
Main Results:
- 63.15% (12/19) achieved ≥50% seizure reduction; 10 were seizure-free.
- EEG improvement observed in one-third of patients.
- Adverse events (rash, seizure exacerbation) led to 3 withdrawals.
Conclusions:
- Lamotrigine monotherapy is effective and safe for newly diagnosed pediatric partial epilepsy.
- Mild, transient side effects (GI, sleep, infections, dizziness) were noted, more in <12 yrs.
- Further studies in younger children are warranted.
Abstract:
Lamotrigine (Lamictal, Glaxo Wellcome) is a drug which is used as add-on therapy in patients with refractory epilepsy. Several previous studies have demonstrated the efficacy of lamotrigine monotherapy, but only few have been done in pediatric patients. The aim of our study was the assessment of efficacy and tolerability of lamotrigine monotherapy in children with newly diagnosed partial epilepsy. Lamictal was used in 19 children (11 boys and 8 girls), aged 3-16 years. 17 patients demonstrated complex partial seizures (with or without secondarily generalisation), 2 children had simplex partial seizures. Symptomatic epilepsy was diagnosed in 10 patients and cryptogenic epilepsy in 9 cases. The drug was administered at the dose of 3.87 +/- 1.02 mg/kg/day during 24 weeks. Three children withdrew from the study because of adverse events: one patient developed rash, two ones seizure exacerbation. Lamictal produced of at least 50% reduction in seizure frequency in 12 (63.15%) children, included 10 seizure-free patients. One third patients experienced EEG improvement. The most common adverse effects were gastrointestinal and sleep disturbances, infections, dizziness, all of them were mild and transient and observed more often in children under 12 years of age. Lamotrigine monotherapy is effective and safe for treatment of newly diagnosed cryptogenic and symptomatic epilepsy with partial seizures but further studies are necessary specially in young children.
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