[P1-60] Outcomes of a Proposed Treatment Strategy for Childhood Absence Epilepsy
Purpose : Childhood absence epilepsy (CAE) is the most common pediatric epilepsy syndrome and attentional deficits are the most important marker of cognitive dysfunction and related with duration of absence seizures. The success of treatment depends on fast remission of clinical seizures. We are determined preliminary outcome in children with CAE who were treatment with temporary combination therapy of valproic acid and lamotrigine.
Method : We retrospectively reviewed the medical charts of children receiving temporary combination treatment of valproate and lamotrigine until March 2015. The temporary combination treatment consists of intravenous valproate rescue (loading dose) and oral valproate maintainance with slow titration of lamotrigine. Eventually, patients receive a monotherapy of lamotrigine after taper-off valproate. Time to seizure-freedom, time to normalized EEG, duration of follow up and clinical characteristics were recorded.
Results : Four patients (all girls) aged 9.7 ± 1.3 (range, 8.0~11.1) years were identified. Mean duration of follow up was 10.2 ± 4.1 months. They took time about 1 or 2 years to treatment from symptom onset. All patients had seizure freedom within 2 weeks after treatment and parents reported improvement of patient’s attention. EEG findings at 4 months were normal in 3 of them. All patients tapered off oral valproate by 4 months and maintained monotherapy of lamotrigine (dose range 4.4 ~ 5.4 mg/kg/day). No adverse events occurred during and after combination treatment.
Conclusion : Using strength of valproate’s faster onset of action and delayed effect of lamotrigine with cognitive advantages, the valproate-lamotrigine temporary combination treatment is a considerable alternative in CAE.
Method : We retrospectively reviewed the medical charts of children receiving temporary combination treatment of valproate and lamotrigine until March 2015. The temporary combination treatment consists of intravenous valproate rescue (loading dose) and oral valproate maintainance with slow titration of lamotrigine. Eventually, patients receive a monotherapy of lamotrigine after taper-off valproate. Time to seizure-freedom, time to normalized EEG, duration of follow up and clinical characteristics were recorded.
Results : Four patients (all girls) aged 9.7 ± 1.3 (range, 8.0~11.1) years were identified. Mean duration of follow up was 10.2 ± 4.1 months. They took time about 1 or 2 years to treatment from symptom onset. All patients had seizure freedom within 2 weeks after treatment and parents reported improvement of patient’s attention. EEG findings at 4 months were normal in 3 of them. All patients tapered off oral valproate by 4 months and maintained monotherapy of lamotrigine (dose range 4.4 ~ 5.4 mg/kg/day). No adverse events occurred during and after combination treatment.
Conclusion : Using strength of valproate’s faster onset of action and delayed effect of lamotrigine with cognitive advantages, the valproate-lamotrigine temporary combination treatment is a considerable alternative in CAE.