Efficacy and Safety of Lamotrigine in Lennox - Gastaut Syndrome

Objective

The Lennox-Gastaut syndrome (LGS), one of the most difficult epilepsy syndromes to treat, is characterized by a triad of intractable seizures of various types, a slow (< 2.5-hertz) spike-wave pattern in EEG and mental retardation. The aim of this study was to evaluate the efficacy and safety of lamotrigine as add-on therapy in intractable epilepsy of children with LGS.

Materials & Methods

In a quasi- experimental study, 40 children with LGS referred to the pediatric neurology clinic of Shaheed Sadoughi Hospital in Yazd, between August 2007 and to November 2008, were evaluated.

Results

Twenty-two boys and 18 girls with a mean age of 4.12 ±1.8 years were evaluated. At the end of three months of treatment with lamotrigine, 12 % were seizure free, 52% had> 50% reduction in seizure frequency and 12% had increase in seizures. Means of seizure frequency/per week, before and after treatment were 70 (range 1-180) and 18.6 (range 0-60) respectively, indicating effectiveness of the drug in seizure reduction (P value = 0.003). The drug was effective in 72 % of mixed type seizures, 40 % of generalized tonic-clonic and 33% of drop attack and tonic seizures. Transient side effects were seen in 12.5 % (drowsiness in 3 and ataxia in 2 children). No serious side effects were seen.

Conclusion

Lamotrigine should be considered as an add-on therapy in management of intractable epilepsy in LGS.