J Korean Epilepsy Soc.  2006 Dec;10(2):133-138.

The Pharmacological Treatment of Pediatric Onset Idiopathic Generalized Epilepsies: The Therapeutic Effects of Topiramate, Lamotrigine, and Valproate

Affiliations
  • 1Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. tsko@amc.seoul.kr
  • 2Department of Pediatrics, Epilepsy Center, Inje University College of Medicine, Sang-gye Paik Hospital, Seoul, Korea.
  • 3Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
The majority of patients with idiopathic generalized epilepsy (IGE) are controlled by an antiepileptic drug when appropriately selected. So far, valproate is regarded as the first-line treatment for IGE. Also, it is postulated that lamotrigine and topiramate may have efficacy in IGE but there are a few evidence to support the usage. We examined the remission rates of seizures on valproate, lamotrigine, topiramate and factors predicting the outcome.
METHODS
We reviewed the patients who diagnosed as IGE in pediatric neurology clinics in Asan Medical Center from March, 1995 to August, 2005. The patients with childhood absence epilepsy and patients without generalized spike and slow waves in EEG were excluded. Data were collected retrospectively on demographics, seizure types, antiepileptic drug treatment details, and remission rates.
RESULTS
64 of 80 patients had achieved one year period of remission by monotherapy with following drugs: Valproate (73.7% of 38 patients), lamotrigine (72.4% of 29 patients) or topiramate (83.3% of 18 patients). Among patients who failed to achieve remission by monotherapy, the combination of the drugs showed a remission rate of 72.7% (8/11 patients). Factors such as age, sex, family history, and history of febrile convulsions did not affect the remission rates. The existence of photoparoxysmal responses or focal epileptiform discharges, and syndrome diagnoses also couldn't be the predictive factors as well.
CONCLUSIONS
As in adult patients with IGE, topiramate and lamotrigine as well as valproate can be used as the most effective anti-epileptic drugs in children with IGE without significant side effect.

Keyword

Idiopathic generalized epilepsy; Valproate; Lamotrigine; Topiramate; Pediatric

MeSH Terms

Adult
Child
Chungcheongnam-do
Demography
Diagnosis
Electroencephalography
Epilepsy, Absence
Epilepsy, Generalized*
Humans
Immunoglobulin E
Neurology
Retrospective Studies
Seizures
Seizures, Febrile
Valproic Acid*
Immunoglobulin E
Valproic Acid
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