Abstracts

Lamotrigine (LTG) is a new antiepileptic drug (AED) that has been approved for use as adjunctive therapy in patients above 2 years for partial epilepsy (PE) or generalized epilepsy (GE) of the Lennox-Gastaut type. The objective of this study was to evaluate the efficacy and tolerability of LTG monotherapy in children. We retrospectively reviewed the records of epileptic children seen at our institution during 2001-2003. Twenty patients (9M, 11F), ages 5-21 years (mean 13 years) were identified. Fifty percent had developmental delay, mental retardation or learning disability. Type of epilepsy was PE in 50%, idiopathic GE (IGE) in 35%, and symptomatic GE (SGE) in 15%. Range of LTG dose was 2-11 mg/kg/day (mean 5 mg/kg/day). Follow-up range was 0.5-9 years (mean 3.2 years). LTG was started as first-line monotherapy in 3 patients (15%), and as adjunctive therapy in 9 (45%), or due to side effects of other AEDs in 8 (40%). Mean number of previous AEDs was 1.6 (range 0-3). Global seizure reduction was as follows: seizure free for an average of 3.5 years in 12 (60%), 75-99% in 4 (20%), 50-74% in 1 (5%), and [lt]25 % in 3 (15%). Overall, 17 (85%) patients showed [gt]50% reduction in seizure frequency. According to epilepsy type, seizure reduction was as follows: PE: [gt]50% in 90%, 70% seizure-free, and [lt]25% in 10%. IGE: 71% seizure-free, and no change in 29%. SGE: [gt]50% in 100%, none seizure-free. The only side effect reported was worsening of myoclonic seizures in one patient. LTG proved to be effective and safe as monotherapy in various types of pediatric epilepsy.