Efficacy of lamotrigine and vigabatrin in drug-resistant epilepsies of childhood

Abstract

It was the purpose of this study to compare the efficacy and side effects of lamotrigine (LTG) and vigabatrin (VGB) as add-on therapy in epilepsies of childhood resistant to conventional drugs. Retrospective analysis of the medical charts and electroencephalograms of 134 children (LTG 57, VGB 77) was performed considering the various epileptic seizures and syndromes. In general, LTG and VGB had similar efficacy, with 30-40% of patients demonstrating significant improvement. Few differences according to seizure type and epileptic syndrome were observed. Primary generalized tonic-clonic seizures more frequently improved and less frequently worsened with LTG than with VGB. In tonic seizures the treatment results were significantly more favorable with VGB. Only insignificantly better results occurred with LTG in the generalized group and with VGB in the localization-related group. VGB was significantly more effective in symptomatic than in idiopathic and cryptogenic syndromes. The frequency of adverse reactions with both drugs was close to 60%. However, treatment had to be discontinued because of severe rashes in only a few patients taking LTG or because of behavior disturbances in patients taking VGB.