ABSTRACT
PURPOSE: We assessed efficacy and safety of adjunctive lamotrigine (LTG) therapy in patients with the Lennox-Gastaut syndrome (LGS). METHODS: The study was a single-center, retrospective chart review of open-label adjunctive LTG therapy in patients with LGS. Initial LTG dose and titration was dependent on concomitant antiepileptic drugs (AEDs). Efficacy was based on the change in seizure frequency between the initiation of LTG therapy and December 1, 1995 (or LTG discontinuation). Seizure diaries were used to count patient seizures. A secondary evaluation of efficacy was a parental or guardian assessment of the patient's global status. The evaluation of safety involved chart review for treatment-emergent adverse events (AE). RESULTS: Data from 16 LGS patients were analyzed. Fifty-three percent (8 of 15) had a > 50% reduction in seizure frequency with LTG adjunctive therapy. Tonic, atonic, generalized tonic-clonic (GTCS), and atypical absence seizure frequency but not myoclonic seizure frequency decreased significantly during LTG therapy. Fifty-three percent of the patient's parents (8 of 15) reported that their child's quality of life (QOL) was much or very much improved during the study. The major treatment-emergent AE were infection (50%, 8 of 16) and sleep disturbance (19%, 3 of 16). A rash was noted in 13% (2 of 16) of the patients and resulted in LTG discontinuation in 1. No clinically significant changes were noted in neurologic examination or laboratory tests during the study. CONCLUSIONS: Our results indicate that LTG adjunctive therapy is effective and well tolerated in patients with LGS.
Subject(s)
Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Triazines/therapeutic use , Adolescent , Adult , Age Factors , Anticonvulsants/adverse effects , Child , Child, Preschool , Databases, Factual , Drug Approval , Drug Eruptions/etiology , Drug Therapy, Combination , Female , Humans , Infections/chemically induced , Lamotrigine , Male , Retrospective Studies , Sleep Wake Disorders/chemically induced , Treatment Outcome , Triazines/adverse effects , United StatesABSTRACT
A previously healthy six year old boy developed severe receptive and expressive aphasia, multifocal epileptiform discharges, and refractory clinical seizures consistent with acquired epileptic aphasia. The patient experienced complete seizure control and almost complete return of language skills following the addition of felbamate. This is the first case of successful treatment of acquired epileptic aphasia using felbamate.
Subject(s)
Anticonvulsants/therapeutic use , Aphasia/therapy , Epilepsy/drug therapy , Propylene Glycols/therapeutic use , Seizures/drug therapy , Child , Electroencephalography , Felbamate , Humans , Language , Male , Phenylcarbamates , Speech , Treatment OutcomeABSTRACT
Public health nurses face ethical decision-making dilemmas in their everyday practice, but how well are they prepared to make these decisions? This research study examined the decision-making capabilities of nurses in case management in regard to terminating and maintaining services in difficult client situations. The results showed that nurses varied in their decision-making capabilities and that their beliefs about case management were not always carried out in actual practice.
