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Vigabatrin treatment in children
A Fois1, S Buoni, R M Di Bartolo
1Institute of Clinical Pediatrics, University of Siena, Italy.
Insights
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.
Abstract:
Sixty-nine children, aged from 2 months to 16 years and suffering from different types of drug-resistant epileptic seizures, mostly complex partial and secondary generalised, were recruited in an open, uncontrolled, prospective study of treatment with vigabatrin (gamma-vinyl GABA). Following a 3-month baseline observation period, the initial dose of vigabatrin of 10 mg/kg per day was progressively increased up to a maximum of 140 mg/kg per day, in addition to the conventional concomitant therapy. Sixteen patients showed a > or = 50% reduction in seizure frequency compared with the baseline, with complete control of seizures in nine cases. In 14 other patients, no substantial change in seizure frequency was observed, although an improvement in psychological performance after vigabatrin treatment warranted further continuation of the drug. In 35 patients vigabatrin was discontinued because of lack of efficacy (22 cases) and/or increased seizure frequency (13 cases). The clinical and biological tolerance of vigabatrin was remarkably good.