Exacerbation of juvenile myoclonic epilepsy with lamotrigine

Non convulsive status epilepticus after replacement of valproate with lamotrigine

“…This observation is in good agreement with the previously well described aggravation of myoclonus in severe childhood epilepsies and juvenile myoclonic epilepsy (JME) [10][11][12][13][14]31] and may point to a common mechanism in these patients. Though LTG is a useful alternative drug in the treatment of IGEs, patients with associated myoclonus, like those with JME should warrant special attention: some patients do not respond as promptly to LTG as to VPA and others may deteriorate with seizure aggravation and NCSE in the worst case.…”

“…Recent reports have demonstrated a seizure aggravating effect of LTG in some childhood epilepsy syndromes such as benign focal epilepsy of childhood with centrotemporal spikes [30], severe myoclonic epilepsy of infancy [10][11][12], Lennox-Gastaut syndrome [13] or juvenile myoclonic epilepsy [31].…”

Evolving Antiepileptic Drug Treatment in Juvenile Myoclonic Epilepsy

“…There are several reports of lamotrigine-induced worsening of myoclonic seizures in the literature. Biraben et al 17 describe worsening of myoclonic seizures in all 7 JME patients treated with lamotrigine. Similar worsening of myoclonic seizures was noted in at least some patients in 4 other series.…”

“…It is thought that lamotrigineinduced worsening probably arises from its sodium channel blocking action, similar to that of phenytoin and carbamazepine, which are known to worsen control of absence and myoclonic seizures in patients with primary generalized epilepsy and JME. 17 In a retrospective study, if the treating physician was not vigilant in documenting an accurate count of seizures at follow-up, worsening of seizure control may mimic poor control. Because of the retrospective nature of our series, an undetected worsening of seizures cannot be entirely excluded.…”

Juvenile Myoclonic Epilepsy: Focus on the Use of Topiramate (Literature Review and Own Data)

“…По данным P. Genton (2000), карба-мазепин вызывал аггравацию приступов при ЮМЭ в 68 % случаев, включая развитие миоклонического статуса у 2 пациентов [24]. Описана и нередкая воз-можность аггравации при применении ламотриджи-на [7,12,17,18,43], что E. Perucca (1999) объясня-ет «физиологической гетерогенностью» ЮМЭ, так как ламотриджин может быть эффективен при этом заболевании [7,45]. Ламотриджин вызывает преи-мущественно аггравацию ТА и ЭМВ; описан 1 слу-чай, расцененный как аггравация ГСП.…”