Document Detail


Vigabatrin for childhood partial-onset epilepsies.
MedLine Citation:
PMID:  22264701     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine vigabatrin's effectiveness and the prevalence of symptomatic visual impairment (i.e., impairment affecting the ability to perform everyday activities) associated with its therapy in pediatric epilepsy, we retrospectively reviewed medical records of 156 patients receiving vigabatrin at Cincinnati Children's Medical Center from 1998-2010. In addition to demographics and vigabatrin dosing information, data included seizure type/frequency at presentation and subsequent follow-up. Of 156 patients, we excluded 35 because their medical records were insufficient to permit verification of the exact duration or timing of vigabatrin treatment. To evaluate efficacy (n = 121/135), we used a 5-point scale (0-4) to compare seizure frequency at several time points. To evaluate visual impairment (n = 63), we reviewed serial ophthalmologic evaluations at baseline and during treatment for patients in whom they were clinically indicated. Mean age at treatment initiation was 1.8 years (range, 0.1-29.2 years). Treatment duration ranged from 0.7-101.0 months, with an estimated average daily dose of 79 mg/kg/day. Tuberous sclerosis complex was the commonest seizure etiology (83%). Partial-onset seizure, alone or with infantile spasms, was the commonest seizure type (84%). Seizure frequency decreased from 3.7 ± 0.6 S.D. at baseline to 1.8 ± 1.7 S.D. at 6 months (P < 0.001). Responses to vigabatrin did not differ by tuberous sclerosis complex or nontuberous sclerosis complex etiology, and were sustained for 5 years. Sixty-three patients (∼50% of all patients evaluated) underwent clinically indicated ophthalmologic assessments during the review period. In our clinical judgment, no cases of clinically relevant vigabatrin-associated visual impairment occurred. Vigabatrin was effective for refractory childhood partial-onset epilepsy, and was not associated with symptomatic vision loss.
Authors:
Hansel M Greiner; Elizabeth R Lynch; Steve Fordyce; Karen Agricola; Cynthia Tudor; David Neal Franz; Darcy A Krueger
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric neurology     Volume:  46     ISSN:  1873-5150     ISO Abbreviation:  Pediatr. Neurol.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-06-04     Revised Date:  2013-01-11    
Medline Journal Info:
Nlm Unique ID:  8508183     Medline TA:  Pediatr Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  83-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anticonvulsants / therapeutic use*
Child
Child, Preschool
Epilepsies, Partial / drug therapy*
Female
Follow-Up Studies
Humans
Infant
Male
Retrospective Studies
Spasms, Infantile / drug therapy*
Treatment Outcome
Vigabatrin / therapeutic use*
Grant Support
ID/Acronym/Agency:
UL1 TR000077/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Anticonvulsants; 60643-86-9/Vigabatrin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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