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08:02
Generation of Local CA1 γ Oscillations by Tetanic Stimulation
Published on: August 14, 2015
Lamotrigine adjunctive therapy for refractory generalized tonic-clonic seizures
Eugene Tjia-Leong1, Kevin Leong, Anthony G Marson
1Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool, UK, L9 7AL.
The Cochrane Database of Systematic Reviews
|December 15, 2010
Summary
Adjunctive lamotrigine shows efficacy in reducing primary generalized tonic-clonic seizures. Further long-term trials are needed to confirm effectiveness and guide clinical practice for this epilepsy type.
Area of Science:
- Neurology
- Clinical Pharmacology
- Epilepsy Research
Background:
- Primary generalized tonic-clonic seizures are a significant epilepsy type requiring effective management.
- Approximately 30% of patients do not achieve seizure control with monotherapy, necessitating combination treatments.
- Controlling these seizures is crucial for reducing injury risk and improving patient quality of life.
Purpose of the Study:
- To evaluate the effectiveness of lamotrigine as an add-on therapy for patients with refractory primary generalized tonic-clonic seizures.
- To synthesize evidence from randomized controlled trials on adjunctive lamotrigine's impact on seizure frequency and adverse events.
Main Methods:
- Systematic search of major databases including Cochrane Epilepsy Group Specialized Register, CENTRAL, and MEDLINE.
- Inclusion of randomized parallel or cross-over add-on trials of lamotrigine for refractory primary generalized tonic-clonic seizures.
- Extraction of data on seizure reduction, cessation, treatment withdrawal, adverse effects, cognitive effects, and quality of life.
Main Results:
- Two trials met inclusion criteria; meta-analysis was not performed due to study design differences.
- A cross-over trial (26 participants) demonstrated a significant 50% reduction in tonic-clonic seizure frequency with lamotrigine.
- A parallel trial (117 participants) showed a significantly greater median reduction in seizure frequency (66.5%) with lamotrigine compared to placebo (34.2%).
- Rash was the primary reason for discontinuation in one trial; dizziness, somnolence, and nausea were common adverse events.
Conclusions:
- Limited evidence from two short-term trials suggests lamotrigine is effective for primary generalized tonic-clonic seizures.
- Current evidence is insufficient to guide clinical practice.
- Longer-term, active-controlled trials are necessary to establish definitive efficacy and safety profiles.
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