Abstracts

Rationale: Pregabalin (PGB), as an add-on therapy, has been found to be safe and effective in patients with partial epilepsy. This study seeks to evaluate the safety and efficacy of Pregabalin in patients with intractable epilepsy and Developmental Disabilities (DD) already tried on other antiepileptic drugs (AEDs). Methods: The charts of 10 patients from the out patient neurology clinic at The Westchester Institute for Human Development and Neurology Associates private practice were reviewed. These patients were tried on Pregabalin as add on therapy due to intractable epilepsy or discontinuation of previous antiepileptic drugs due to adverse effects. The patients mostly have mixed seizure disorder. Data was reviewed six months before starting pregabalin and up till their last clinic visit. Results: The charts of 4 women and 6 males were reviewed. Age ranged from 35-63 (mean 47.1years). Follow up ranged from 3 to 29 months. The level of mental retardation (MR) was borderline-1, mild-3, moderate-2, severe-2 and 2 profound. The dose of PGB ranged from 150-600mg daily. Most patients had a mixed seizure disorder. The majority had idiopathic epilepsy. One had documented complex partial with secondary generalization associated with mesial temporal sclerosis (MTS). One had Tuberous Sclerosis (TS). The majority of patients were on three antiepileptic medications within the six months prior to PGB initiation. Most patients had a reduction in the dose of these AEDs. Carbamezapine was most commonly stopped because of adverse effects. One patient reported a mild headache with initiation but it resolved. There were no other adverse effects and there was no discontinuation of PGB. Five patients had a greater than 75% reduction in seizure frequency over the course of follow up. Two had a 50% reduction. One stayed the same with rare seizures but the carbamezapine was stopped because of adverse effects. One became seizure free. One patient had a reported increase in frequency at 3 months of follow up. This patient has right MTS with CPS documented by MRI and video EEG monitoring. EEG also revealed multiple electrographic seizures without a clinical event so there is likely under reporting of actual seizures. Conclusions: Individuals with DD and refractory epilepsy benefited significantly from the addition of PGB with no reported side effects. There were no differences between level of MR or sex and seizure reduction with PGB