Abstracts

Rationale: Epilepsy is a seizure disorder that affects approximately 1.2 million Americans. Of these, 70% have partial onset seizures. 30% of these individuals remain medically intractable. For these patients who have failed multiple classes of antiepileptic drugs (AEDs) and/or surgical procedures, newly FDA-approved drugs are of particular interest. Vimpat, a 2nd generation antiepileptic drug with two novel mechanisms of action, was approved in 2008 in United States as adjunctive therapy in the treatment of partial onset seizures. We hypothesize that per oral Vimpat will be efficacious and safe for use in the reduction of number of seizures in patients with intractable epilepsy. Methods: A retrospective chart review was conducted on all patients with intractable epilepsy who received Vimpat at Scott & White Neurology Clinic/ Texas A & M Health Science Center, Temple, TX between October 2008 and June 2010. Effectiveness was evaluated by comparing seizure frequency of patients with intractable partial epilepsy on their prior AEDs to the seizure frequency after adding Vimpat to their treatment regime. The study patients were followed for a period of 3-12 months following the addition of Vimpat. Subject data were acquired from electronic medical records. Approval for this retrospective analysis of patient records was given by the hospital s Institutional Review Board. Results: We retrospectively analyzed 10 patients who received Vimpat for intractable epilepsy. The study population consisted of 10 patients (mean age: 44 years, range: 16 - 75 years). All patients had partial epilepsy. Subjects were initially treated with 50 mg p.o. b.i.d. of Vimpat . If Vimpat was tolerated and the patient s seizures were not well controlled , the dosage was increased to 100 mg p.o. b.i.d The study patients have failed an average of 4.1 antiepileptic drugs (range 1-8). (20%) became seizure free following initiation of Vimpat . The 8 patients who were not seizure free on Vimpat showed an average decrease of 64% in number of seizures per month. The monthly seizure frequency was reduced in all patients by at least 50% (range 50-100%). No immediate or long term side effects were reported. Duration of follow up was 3 - 12 months. Conclusions: Our data analysis suggest that Vimpat may be safe, efficacious, and well tolerated in reducing the frequency of seizures in intractable epilepsy patients who have failed multiple anticonvulsants.