Efficacy and safety of lamotrigine in lennox - gastaut syndrome

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