Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

Abstract

-Objective: To evaluate the efficacy or eventual side-effects of the association of lamotrigine and sodium valproate in the control of refractory epilepsies. Method: A retrospective analysis of 37 children with a mean age of 12 years taking exclusivelly lamotrigine and sodium valproate. Efficacy of seizure control was considered satisfactory if there was a reduction in seizures ≥50% or total control. Results: The association of lamotrigine and sodium valproate was considered satisfactory in 65% of the studied children, independent of seizure type. Total seizure control was obtained in 33% and 35% had an unsatisfactory response or remained unchanged. Primary generalized tonic clonic seizures were the most common type with 84% of day-time seizures having a good response to treatment. Side-effects were seen in 11% of patients and the most common was tremor. Conclusion: Total or satisfactory control of seizures was seen in the majority of patients and sideeffects were uncommon.KEy wordS: epilepsy, refractory, valproate, lamotrigine, childhood. Associação de lamotrigina e valproato de sódio no tratamento de epilepsia refratária em crianças e adolescentesResumo -Objetivo: Avaliar a eficácia ou eventuais efeitos colaterais da associação de lamotrigina e valproato de sódio no controle de epilepsia refrataria. Método: Análise retrospectiva de 37 crianças e adolescentes com idade média de 12 anos tratadas exclusivamente com lamotrigina e valproato de sódio. A eficácia do controle de crises foi considerada satisfatória se o controle das crises foi ≥50% ou total. Resultados: A associação de lamotrigina e valproato de sódio foi considerada satisfatória em 65%, independente do tipo de crise. o controle total de crises foi obtido em 33% e em 35% a resposta foi insatisfatória ou permaneceu inalterada. Crise generalizada primaria tônico clonica foi o mais comum, com 84% das crises ocorrendo durante o dia, com boa resposta ao tratamento. Efeitos colaterais foram vistos em 11% dos pacientes, sendo tremor o mais freqüente. Conclusão: Controle total ou satisfatório das crises ocorreu na maioria dos pacientes, sendo pouco freqüente os efeitos colaterais.

Turner Syndrome Associated With Refractory Seizures and Intellectual Disability: A Case Study

“…Efficacy of seizure control was considered satisfactory if there was a reduction in seizures >50% or total control. They revealed a satisfactory treatment response was obtained in 65% of children with this combination therapy [ 15 ]. In contrast to a previous case study using LTG/VPA combination, our patient’s seizures were reduced significantly by about 50% [ 12 ].…”

“…Clobazam (dosage of 0.2 mg/kg/day) was added, but her seizures did not improve, moreover, it led to drowsiness, and then we reduced the dosage (0.1 mg/kg/day). We decided to treat her with combination therapy of LTG (2 mg/kg/day) and VPA (dosage was 8 mg/kg/day) because previous reviews have suggested a good response in controlling refractory seizures with combination therapy [ 14 , 15 ]. Her seizure frequency reduced by approximately 50%.…”