Vigabatrin-induced generalized epileptiform discharges in a patient with focal epilepsy

Vigabatrin (VGB) may aggravate clinical seizures and epileptiform discharges especially in the patients with generalized epilepsy. This report is about the repetitive appearance of generalized spike-and-wave complexes in a patient with focal epilepsy. Though there were constant appearances of the generalized epileptiform discharges on the consecutive electroencephalograms (EEGs) taken over approximately four years under VGB monotherapy, clinical provocation of primary generalized seizures was not occurred. Because of the repetitive observations of the generalized epileptiform discharges, valproic acid was added and the tapering of VGB was started. On the EEG taken during the tapering period of VGB and another EEG after the discontinuation of VGB, the generalized epileptiform discharges were completely disappeared. Through observation in this case, we suggests that the use of VGB could induce generalized epileptiform discharges without clinical seizure induction for long term period.