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Vigabatrin treatment in children
A Fois1, S Buoni, R M Di Bartolo
1Institute of Clinical Pediatrics, University of Siena, Italy.
Summary
Vigabatrin showed good tolerance in children with drug-resistant epilepsy. While some patients achieved seizure reduction, others discontinued the treatment due to lack of efficacy or increased seizure frequency.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Epilepsy affects numerous children globally, with a significant subset exhibiting drug-resistant seizures.
- Managing drug-resistant epilepsy in pediatric populations presents unique therapeutic challenges.
Purpose of the Study:
- To evaluate the efficacy and tolerability of vigabatrin (gamma-vinyl GABA) in children with various types of drug-resistant epileptic seizures.
- To assess the impact of vigabatrin on seizure frequency and psychological performance in pediatric patients.
Main Methods:
- An open, uncontrolled, prospective study involving 69 children (2 months to 16 years) with drug-resistant epilepsy.
- Vigabatrin dosage was escalated from 10 mg/kg/day up to 140 mg/kg/day, alongside conventional therapy, after a 3-month baseline observation.
Main Results:
- Sixteen patients (23%) experienced a ≥50% reduction in seizure frequency, with nine achieving complete seizure control.
- Fourteen patients showed no significant change in seizure frequency but improved psychological performance.
- Vigabatrin was discontinued in 35 patients due to lack of efficacy (22) or increased seizure frequency (13).
- The drug demonstrated remarkable clinical and biological tolerance.
Conclusions:
- Vigabatrin offers a potentially beneficial treatment option for a subset of pediatric patients with drug-resistant epilepsy, particularly those with complex partial and secondary generalized seizures.
- Despite variable efficacy, the drug's good tolerability profile supports its consideration in this population, with psychological benefits noted in some non-responders.