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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 1998 June;157(3):71-3
Vigabatrin and lamotrigine in intractable secondary epilepsies. Personal experience
Perini M., Lischetti M. R., Buganza V., Sala M.
Istituto Sacra Famiglia, Cesano Boscone - Milano
Background. Several new antiepileptic drugs (AED) have been proposed in the last years to reduce seizures in intractable epilepsy.
Methods. We studied the therapeutical effects, electroencephalogram (EEG) modifications and side effects of two AED, vigabatrin and lamotri-gine, on a cohort of 9 patients affected by cerebral palsy, with severe mental deterioration and epilepsy (several generalized atonic or tonic seizures in a week). We began to introduce Vigabatrin to previous therapy.
Results. After 3 months we noted in 4 cases an initial good response to vigabatrin, with 50% seizures reduction and EEG improvement. Behaviour abnormalities were reported in one patient. However, after one year treatment, in all cases we noted an increase in seizures number and EEG abnormalities. Gradually vigaba-trin was sobstituted by lamotrigine. After 3 months therapy we noted in 6 cases a good response to lamotrigine, with 50% seizures reduction and EEG improvement. Vomiting due to increase plasma valproate sodium concentrations was reported in one patient. With lamotrigine, this good response was still present after one year treatment.
Conclusions. In our cohort of 9 patients, after initial good therapeutical response, vigabatrin partially lost its effects in a year even if seizures frequency was still reduced in comparison with the number of attacks before this therapy. Substitution of vigabatrin with lamotrigine was useful, in our patients, to obtain a better control of seizures number and EEG abnormalities in the first year. We are monitoring these data, in order to control lamotrigine efficacy in next years.