Abstracts

Rationale: Rufinamide (RUF) has demostrated efficacy as adjuntive therapy in adult patients with partial seizures and it has been aproved as adjuntive therapy in patients with Lennox- Gastaut syndrome. Lennox-Gastaut is a catastrophic pediatric epilepsy syndrome characterized by the triad of slow spike and wave pattern on EEG, multiple types of seizures (tonic/atonic, atypical absences and generalized tonic-clonic seizures) and impaired mental development. Objetive . To present the long term efficacy of RUF in the everyday clinical practise in pediatric and adult patients. Methods: Multicentric, retrospective study including patients with generalized and focal epilepsies treated with RUF as adjuntive therapy, followed 1 year. Efficacy and safety variables were recorded at 6 month and at 1 year. All seizures were classified according the International League Against Epilepsy Revised Classification of Seizures. Tonic and atonic seizures were considered in the same seizure group. Results: 39 patients ,26 men-13 women. Mean age 28 (range 7-57), mean age at epilepsy onset 3.7 ( range 0-43). 27 (69%) patients were diagnosed of Lennox-Gastaut syndrome or generalized epilepsy with impaired mental development and 8 (21%) patients were diagnosed of focal epilepsies, mainly frontal lobe epilepsies. Connatal anoxia was the most frequent aetiology 10 (25.6%). Mean RUF dose was 1363 mgr ( range 400-3200), mean RUF dose/Kg en children 32.7 (range 12.5-66.67 mgr/Kg) , mean RUF dose/Kg in adults 22.2 ( range 5-47mgr/Kg) . All patients were treated with RUF on polytherapy, the most frequent associated AED was VPA 20 (51%). 17 patients (44%) discontinued RUF during the 1 year follow up and the main reason for discontinuation was lack of efficacy 10/17 (58.8%). Mean pretreament mensual tonic/atonic seizures 26 , generalized tonic-clonic seizures 3.09 ,atypical absences 49, other (partial) 22. Significative generalized tonic-clonic seizure reduction was observed at 6 months (p:0.013) and at 12 months (p:0.018) in both generalized and partial epilepsies. A tendency in other seizure type reduction was also observed at 6 months (p:0.06). 15 patients referred adverse events 38.46%, being the most frequent nausea , vomiting and weight loss. Conclusions: RUF was well tolerated in a huge range of dosis showing efficacy in reducing generalized tonic- clonic seizures both in adults and in children with severe epilepsies mainly Lennox-Gastaut Syndrome.