Abstract
OBJECTIVE: To review our experience with Co-administration of Valproic acid and Lamotrigine in the treatment of refractory epilepsy BACKGROUND: Studies and experience showed that combination use of Valproic acid and Lamotrigine has synergistic effect on the treatment of refractory epilepsy. But there is no enough evidence to guide the combination therapy. It is unclear which type of epilepsy response well to the co-administration. DESIGN/METHODS: By chart review, our epilepsy clinic patients (both adult and pediatric) who is/was on combination therapy of valproic acid and Lamotrigine for at least 6 months and followed with us regularly at least 2 years were identified and included; the epilepsy type, baseline seizure frequency, and EEG feature before and after the co-administration were recorded. The primary outcome measure was change in baseline seizure frequency and EEG. RESULTS: Total 29 patients were included. 23 patients (79[percnt]) have generalized epilepsy; and 6 patients (21[percnt]) have focal onset epilepsy; 7 patients EEG showed Lennox- Gastaut feature; 2 patients had EEG findings of ESES (Electrical status epilepticus in sleep). 27 patients were on at least one other AEDs in combination. Comparing seizure frequency and EEG change before and after the combination, 13 patients (45[percnt]) improved (at least 50[percnt] reduction in baseline seizure frequency; 7 out of the 13 patients (24[percnt] of all patients) became seizure free; 3 out of 6 focal onset epilepsy patients (50[percnt]) improved. 10 out of 23 patients (43[percnt]) with generalized epilepsy improved; 3 out of 7 patients (43[percnt]) with Lennox- Gastaut syndrome improved. Both patients with EEG ESES feature became seizure free. CONCLUSIONS: Co-administration of Valproic acid and Lamotrigine should be considered to treat both generalized and focal onset refractory epilepsy; refractory epilepsy with EEG features of Lennox-Gastaut or ESES might response to the combination use of Valproic acid and Lamotrigine.
Disclosure: Dr. Jiang has nothing to disclose.
Monday, April 20 2015, 2:00 pm-6:30 pm
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