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Vigabatrin in the treatment of epilepsy in children.

1989; Wiley; Volume: 27; Issue: S1 Linguagem: Inglês

10.1111/j.1365-2125.1989.tb03470.x

1365-2125

J. H. Livingston, D Beaumont, Alexis Arzimanoglou, Jean Aicardi,

Neuroscience and Neuropharmacology Research

1. This study presents the results of the preliminary screening of vigabatrin as add‐on therapy in an open, non‐controlled multicentre study in children with refractory epilepsy. 2. There were 135 children, with an age range of 2 months‐12 years. Main seizure type was partial in 42%, generalized in 29%, Lennox‐Gastaut syndrome in 19% and West syndrome in 10%. 3. Vigabatrin was added onto current antiepileptic treatment in an initially recommended dose of 40‐80 mg kg‐1 day‐1. However, the doses were frequently increased when tolerance allowed it, and the final mean dose used was 87 mg kg‐1 day‐1 (27‐600). 4. A 75% to 100% reduction in seizure frequency was observed in 25% of patients (11 patients became seizure free) and 50 to 75% decrease in a further 13%. Efficacy was better in partial seizures, with good to excellent results in 49% of patients. The use of high doses, above 100 mg kg‐1 day, was not associated with greater efficacy in this preliminary study. 5. No side effects were reported in 79% of patients. Agitation and insomnia were observed in 8.8% and somnolence in 6%. Other adverse events included ataxia (2.2%), nausea (2.2%) and increased appetite (1%). A moderate and transient decrease in haemoglobin was reported in six patients from the same centre; these patients were all receiving very high doses of vigabatrin (250 to 600 mg kg‐1 day‐1). 6. Vigabatrin thus appears to be a safe antiepileptic drug that may be effective in the treatment of severe epilepsy in children.