Vigabatrin in infantile spasms

Chiron, Catherine; Dulac, Olivier; Luna, David; Palacios, León; Mondragon, Sylvie; Beaumont, Daniel; Mumford, J. P.

doi:10.1016/0140-6736(90)90660-w

Cited by 83 publications

(27 citation statements)

References 5 publications

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“…The present analysis verifies that visual field constriction, when it occurs, is most often mild or moderate and is not associated with symptoms INTRODUCTION Vigabatrin (Sabril  ), a selective and irreversible γ-aminobutyric acid transaminase inhibitor (Ben-Menachem, 1995), is effective as adjunctive therapy for adult patients with refractory complex partial seizures , French et al, 1996, Sander et al, 1990 and as monotherapy for infants with infantile spasms (West syndrome) (Aicardi et al, 1996, Appleton et al, 1999, Chiron et al, 1990, Chiron et al, 1997, Elterman et al, 2001, Wohlrab et al, 1998. Vigabatrin has been approved for these indications in the United…”

Section: Discussionmentioning

confidence: 99%

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Sergott¹

2011

Yearbook of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Sergott¹

2011

Yearbook of Ophthalmology

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“…1,2 Vigabatrin is one of the new antiepileptic drugs (AEDs) that are particularly useful for the management of drug-resistant partial seizures and infantile spasms. [3][4][5][6] It is considered by many to be the drug of choice for children with infantile spasms secondary to tuberous sclerosis. 7 Vigabatrin has been in clinical use for a decade, and commonly seen side effects were considered to be relatively minor.…”

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confidence: 99%

Visual impairment in children with epilepsy treated with vigabatrin

et al. 2000

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Vigabatrin is an anti‐epileptic drug particularly useful for drug‐resistant partial seizures and infantile spasms. Recently, vigabatrin‐induced visual field constriction (VFC) and abnormal ocular electrophysiological studies were reported. In this study, we assessed visual fields, visual evoked potentials (VEPs), and electroretinography (ERG) in children treated with vigabatrin. Twenty‐four visually asymptomatic children underwent a clinical ophthalmological examination, perimetry when appropriate, and VEP and ERG. Thirteen patients had at least one abnormal study. VFC was seen in 11 of 17 patients who had perimetry; 5 of 15 patients who underwent VEP testing and 4 of 11 who underwent ERG testing had abnormal examinations. For the most part, abnormal VEPs and ERGs were found in children who also had VFC. There was a consistent trend for longer treatment periods to correlate with VFC, abnormal ERGs, and VEPs. In summary, over half of the children treated with vigabatrin demonstrated VFC or abnormal ocular electrophysiological studies. Perimetry seemed to be the most sensitive modality for identifying vigabatrin toxicity. Abnormal ERGs and VEPs were primarily seen in children with VFC and may be useful in monitoring children who are not appropriate candidates for perimetry. Although the incidence of vigabatrin‐induced VFC is worrisome, in the context of intractable seizures or infantile spasms, therapeutic benefits must be weighed against risks. Ann Neurol 2000;48:60–64

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“…Many patients respond dramatically to corticotropin, with cessation of seizures after one or two doses, but treatment failures are common. Medications reported to be occasionally effective include pyridoxal phosphate (Blennow and Stark, 1986;Ohtsuka et al, 1987), highdose corticotropin (>lo0 U/day) (Riikonen and Donner, 1980;Snead et al, 1983;Snead, 1990), highdose valproate (PaNone et al, 1981;Dyken et al, 1985;Siemes et al, 1988), and nitrazepam, y-vinyl-yaminobutync acid (Chiron et al, 1989;Livingston et al, 1989;Auerswald et al, 1991). Infantile spasms also have been reported to stop spontaneously, so evaluation of a therapeutic regimen that controls only a small percentage of patients is difficult.…”

Section: Medical Treatment Of Infantile Spasmsmentioning

confidence: 97%

Treatment of Infantile Spasms: Medical or Surgical?

et al. 1992

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Although infantile spasms were initially described in 1 84 I , remarkably little progress has been made in understanding the pathophysiology of this "peculiar form of infantile convulsions." Consequently, our ability to treat infantile spasms is limited. Infantile spasms are classified as a "generalized" seizure disorder in the international classification system, which suggests that the underlying brain abnormality causing the seizures also must be diffuse or generalized. As the classification suggests, there are many diffise, or multifocal, brain disorders related to infantile spasms, e.g, inborn errors of metabolism, hypoxic-ischemic brain injury, and developmental brain defects such as tuberous sclerosis or Aicardi's syndrome. On the other hand, infantile spasms have been reported in which a localized brain abnormality was present, e.g., tumor, stroke, and trauma. On rare occasions, removal of a tumor has resulted in cessation of the generalized infantile spasms. This finding suggests that focal cortical abnormalities can cause infantile spasms and that removing the abnormality can stop the seizures. At University of California, Los Angeles, the Pediatric Epilepsy Surgery Program has developed new approaches to the treatment of infantile spasms. The principal underlying concepts are (a) children with medically refractory infantile spasms may have an area of cortical defect (called the zone of cortical abnormality) that causes the seizures and (b) infantile spasms are usually generalized seizures. Thus, the goal of the surgical assessment is not the identification of the focus of seizure onset but rather the identification of the zone of cortical abnormality.

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Vigabatrin in infantile spasms

Cited by 83 publications

References 5 publications

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Vigabatrin-induced peripheral visual field defects in patients with refractory partial epilepsy

Visual impairment in children with epilepsy treated with vigabatrin

Treatment of Infantile Spasms: Medical or Surgical?

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