Lamotrigine as an add-on therapy in intractable paediatric epilepsy--the Kuala Lumpur Hospital experience
G Vigneswari1, A Sofiah, I H Hussain
1Neurology Unit, Paediatric Institute, Kuala Lumpur Hospital, Jalan Pahang, 50586, Kuala Lumpur.
Insights
Lamotrigine shows promise as an add-on treatment for childhood intractable epilepsy. In this study, many children experienced reduced seizure frequency or became seizure-free, with some showing improved alertness.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Intractable epilepsy in children presents significant treatment challenges.
- Exploring novel therapeutic options is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and tolerability of Lamotrigine as add-on therapy in pediatric patients with intractable epilepsy.
- To assess the impact of Lamotrigine on seizure frequency, severity, and behavioral aspects.
Main Methods:
- Observational study of 30 children with intractable epilepsy receiving Lamotrigine as add-on therapy.
- Data collected on seizure control, adverse effects, and behavioral changes over the study period.
- Analysis of seizure reduction, response rates, and tolerability.
Main Results:
- Six children (20%) achieved seizure freedom, and 14 (54%) had over a 50% reduction in seizure frequency.
- Seven children (23%) did not respond to Lamotrigine, and three experienced worsened seizure severity.
- Nine children showed improvements in alertness and behavior; three discontinued due to adverse effects.
Conclusions:
- Lamotrigine appears to be a potentially useful add-on therapy for managing intractable epilepsy in children.
- The drug demonstrated a favorable response rate in a significant proportion of the studied pediatric population.
- Further research is warranted to confirm these findings in larger cohorts.
Abstract:
An observational study of all children with intractable epilepsy at the Paediatric Institute prescribed Lamotrigine as an add-on therapy between January 1994 and November 1998 was conducted. A total of 30 children were recruited. Three had adverse effects to the drug and it was withdrawn. Of the remaining 27, there were 20 boys and 7 girls, ranging from 2 to 17 years. Fifteen children had generalised epilepsy, 6 had partial epilepsy, 2 had West syndrome and 4 had Lennox Gastaut syndrome. Six children (20%) became seizure free, and 14 (54%) had a greater than 50% reduction in seizure frequency. However 7 children (23%) did not respond and 3 experienced a deterioration in seizure severity. Nine children were noted to have an improvement in alertness and behaviour. Our small series suggests that Lamotrigine is useful as add-on therapy in childhood intractable epilepsy.
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