FREQUENCY OF MYOCLONIC SEIZURE EXACERBATION BY LAMOTRIGINE IN JME
Abstract number :
2.268
Submission category :
Year :
2003
Submission ID :
4098
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Jesus F. Martinez, Nathan B. Fountain Fritz E Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA; Fritz E Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia,
It has been reported that lamotrigine (LMT) commonly exacerbates myoclonic seizures due to juvenile myoclonic epilepsy (JME) but others have reported less frequent exacerbations. We retrospectively examined the response of our patients with JME to LMT therapy to determine whether they had worsening of myoclonic and other seizure types.
Patients with JME and taking LMT were identified from the University of Virginia Epilepsy Database. Demographic data, seizure characteristics, medications and side effects were collected from charts and analyzed. The frequencies of myoclonic, generalized tonic clonic (GTC), and absence (ABS) seizures prior to LMT therapy were compared to the frequencies at 3, 6 and 12 months of follow up after initiation of LMT by paired t-tests.
65 patients with JME were identified and 22 were taking LMT. 15 patients had follow up at 3 and 6 months, and 11 patients had follow up for 12 months or more. Mean current age was 32.5[plusmn]11.2 years, mean age of onset was 17.9[plusmn] 8.32 years. Male to female ratio was 1:2. A history of GTC was present in 11, myoclonic in 11, and ABS in 2. Greater than 50% seizure reduction occurred at 3,6 and 12 months in 9 (72%), 11 (100%, p[lt]0.05) and 11 (100%, p[lt]0.05) for GTC, respectively, and in 6 (40%),11 (73.3 %), and 6 (54.5%) for myoclonic. At 12 months, all patients with GTC became seizure-free and 6 (54%) patients were free of myoclonic seizures. ABS seizures were present in 2 patients that completed 12 months of follow up, both of whom became seizure free. Myoclonic exacerbation was seen in 2 patients during the first 3 months of therapy but this subsided in less than 12 months and both became seizure-free at 12 months of follow up. One patient (5%) reported myoclonic exacerbation 9 months after initiating LMT and was the only person who discontinued LMT due to worsened myoclonic seizures.
LMT is commonly effective for seizure types encountered in JME. LMT only very rarely exacerbates myoclonic seizures in JME, as only one patient in this study had an exacerbation sufficient to discontinue LMT and only 2 patients had transient exacerbations. This suggests that myoclonic seizure exacerbations may be transient and may explain disparity in previous reports.