China
Africa
Explore chapters and articles related to this topic
Felbamate
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Ilo E. Leppik, Harvey J. Kupferberg
A new model for evaluation of novel antiepileptic drugs (AEDs) using patients whose other AEDs have been reduced or discontinued for inpatient presurgical evaluation has been used for FBM (17). Three phases were evaluated: baseline = no change from admission AED; diagnostic = AED withdrawn to provoke seizures; and treatment = FBM added. The participants were IS patients (8 women, 7 men) ages 21 to 58 (mean, 35) years with intractable epilepsy. In baseline, the mean number AED per patient was 1.86 and the mean of all seizure types was 0.65/day. During the diagnostic phase, the mean number of AED per patient was 1.1, and mean number of seizures 2.05/day. Treatment consisted of FBM 3600 mg/day added to AED dosage at end of diagnostic phase. The mean number of seizures during treatment was 0.29 day significantly less compared to diagnostic (p < 0.001) and baseline (p < 0.05) phases. A number of other efficacy studies are in progress. Some of these involve use of FBM as monotherapy. One is a study of children with the Lennox-Gastaut syndrome.
Antiepileptic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Lamotrigine is used as single drug and as add-on therapy for focal (Brodie et al., 1995; Steiner et al., 1999) and secondarily generalized tonic–clonic seizures in adults. It is also efficacious for Lennox–Gastaut syndrome in both children and adults (Motte et al., 1997).
Occupational Therapy and Epilepsy
Published in Jerry A. Johnson, David A. Ethridge, Developmental Disabilities: A Handbook for Occupational Therapists, 2013
Severe childhood epileptic encephalopathy characterized by a variety of intractable seizure forms including absence and drop attacks, associated with mental retardation, and having an irregular, slow, spike and wave EEG pattern has been described by a large number of seizure combination descriptions. This syndrome is now commonly called Lennox-Gastaut syndrome.
Fenfluramine hydrochloride for the treatment of Dravet syndrome
Published in Expert Opinion on Orphan Drugs, 2020
Blandine Dozières-Puyravel, Stéphane Auvin
The most intriguing question is that fenfluramine may have a special effect in DS compared to any other epilepsy syndrome. It seems that the MoA of fenfluramine is multiple, acting through 5-HT1D, 5-HT2C, and σ1 receptors and through a reduction in dopamine and noradrenaline levels [25]. The effect of fenfluramine on σ1 receptors has been further established by a recent radioligand binding and cellular function study [29]. However, a significant decrease in serotonin levels in the heads of homozygous scn1Lab(-/-) mutants compared to those in wild-type zebrafish was found, suggesting that neurochemical defects might play a crucial role in the pathophysiology of DS. Fenfluramine might then act with particular efficacy in DS due to the special neurobiological state in this syndrome. Recent data in another epilepsy syndrome, Lennox-Gastaut syndrome, found a positive effect of fenfluramine in a smaller extent than in DS [33,34]. It is still insufficient to conclude on the special effect in DS. Lennox-Gastaut syndrome is a heterogeneous syndrome with various underlying etiologies and levels of severity in the electroclinical phenotypes. We need to wait for future trials evaluating fenfluramine in the treatment of homogeneous epilepsy syndrome to conclude on the special effect of fenfluramine in DS.
An evaluation of clobazam tablets and film (AQST-120) for the treatment of Lennox-Gastaut syndrome
Published in Expert Opinion on Pharmacotherapy, 2019
Frank M.C. Besag, Michael J. Vasey
Lennox-Gastaut syndrome (LGS) is an age-specific, chronic epileptic encephalopathy characterized by the triad of 1) multiple seizure types, primarily tonic, atonic and atypical absences 2) abnormal electroencephalogram (EEG) with waking diffuse slow (2–2.5 Hz) spike-wave patterns and paroxysmal fast rhythms during sleep, and 3) cognitive and behavioral impairment and/or regression [1]. Onset is typically before the age of 8 years, most commonly between the ages of 3 and 5 years [1]. Incidence is estimated to be between 1% and 10% of childhood epilepsies [2]. European studies estimate a prevalence of 0.1–0.28 per 1000 population [3] with boys more affected than girls (relative risk 5.31) [4]. Diagnosis is complicated by heterogeneous clinical presentations: not all patients will show the indicative seizure types at onset nor is the characteristic EEG itself pathognomonic [5]. Etiology is also diverse: genetic mutation, developmental abnormality, pre-, peri- or neo-natal brain insult, infection and tumor may all be implicated [5,6]. Approximately one-fifth of cases progress from West syndrome [2], an epileptic syndrome with onset in infancy or early childhood, typically during the first year, characterized by the clinical triad of clustered spasms, hypsarrhythmic EEG, and developmental delay or regression [7]. Cause is undetermined in 25–33% of LGS cases [6]. After seizure onset, developmental impairment or regression is seen in most patients: autistic traits and other behavioral and/or cognitive disabilities may be present in more than 50% of cases [8,9].
A resurging boom in new drugs for epilepsy and brain disorders
Published in Expert Review of Clinical Pharmacology, 2018
Iyan Younus, Doodipala Samba Reddy
Trial of cannabidiol therapy for Lennox–Gastaut syndrome is a double-blind, placebo-controlled trial including 171 patients (NCT02224690). The patients were randomized to receive oral cannabidiol (20 mg/kg) or placebo, in addition to standard antiepileptic treatment [36]. The primary outcome measure was change in drop seizure frequency from baseline over the 14-week treatment period. The results showed that cannabidiol resulted in a significantly greater median percent reduction in drop seizure frequency, 44% to 22% for the placebo group. The most common adverse events reported for the cannabidiol group include diarrhea, somnolence, pyrexia, decreased appetite, and vomiting. Results from both clinical trials establish that cannabidiol resulted in a markedly greater reduction in seizure frequency than placebo. These trials demonstrate efficacy of cannabidiol as add-on therapy for Dravet syndrome and Lennox–Gastaut syndrome.