Efficacy of lamotrigine with add-on treatment in outpatients with refractory epilepsy / Efficacy of lamotrigine with add-on treatment in outpatients with refractory epilepsy

RESUMO

The efficacy of lamotrigine (LTG) was evaluated in 30 patients with epilepsy resistant to previous treatments. They were 16 females and 14 males, aged 30.2 + or - 7.7 (mean + or - sd) years. They had localization-related epilepsy (26 temporal, 1 frontal, 1 parietal). Lennox-Gastant syndrome (1) and juvenile myoclonic epilepsy (1). Duration of epilepsy was 20.9 + or - 9.8 years. Age at onset of epilepsy was 9.2 + or - 8.3 years. CT showed static lesions in 16 cases. EEGs showed localized abnormalities in 28 cases and a generalized abnormality in two. At the time of the study therapy was carbamazepire (24 cases), valproate (11), phenobarbitone (5) and phentoin (4). In the 3 months before the study they had respectively 21.6 + or - 28.1; 22.8 + or - 28.4 and 21.1 + or -27.2 seizures per month. In the 3 months of the trial on progressive doses of LTG 50-400 mg daily, the seizune frequencies were respectively 5.2 + or - 7.3, 6.5 + or - 10.2 and 5.4 + or - 9.8. These results indicate an improvement or greater than 75 per cent compared to the average of baseline (p=0.0054). Serum antiepileptc drug concentrations, biochemical and hematological measurements were unchanged. We observed the following side-effects of the AEDs dizziness, asthnia, diplopia, anorexia, insomnia and somnoience. These favorable observations on the efficacy of LTG in refractory epilepsy obtained in open trial, may reflecty our selection of outpatients with little neurological impairment and the rational approach to polytherapy.