Lamotrigine therapy in juvenile neuronal ceroid lipofuscinosis.
OBJECTIVE
To evaluate the effects of lamotrigine (LTG) therapy on epileptic seizures and general well-being in patients with juvenile neuronal ceroid lipofuscinosis (JNCL).


METHODS
LTG was initiated in 28 patients with JNCL. The mean age of the patients at the initiation of LTG was 13.7 years (range, 6.7-28.2 years). LTG was started at a dosage of 0.1-0.5 mg/kg/day and increased every 2 weeks until a maintenance dose of 1.25-15 mg/kg/day was reached. On the basis of the indication for LTG therapy, the patients could be divided into four groups. In the first group, LTG was initiated on an add-on basis; in the second group, LTG was started as the first antiepileptic drug (AED) because of seizures, and in the third group, despite no preceding seizures, because of epileptiform activity in the whole-night polysomnography; in the fourth group, LTG replaced valproate (VPA), which was discontinued because of adverse side effects. The efficacy was assessed after 1 year on LTG. The mean follow-up time was 2.8 years (range, 1.3-5.8).


RESULTS
LTG had a favorable effect in 23 of 28 patients. A decrease in frequency of seizures of > or =50% was observed in 10 and a decrease in severity of seizures in nine of the 22 patients who had preceding seizures. Increases in well-being were found in 18 of 28. During the follow-up, LTG was continued as monotherapy in 13 of 19 patients.


CONCLUSIONS
In light of our experiences, LTG seems to be a valuable drug in JNCL.
Aberg
L
L
Department of Pediatric Neurology, Hospital for Children and Adolescents, University of Helsinki, Finland.
Kirveskari
E
E
Santavuori
P
P
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D009472:Neuronal Ceroid-Lipofuscinoses / Q000188:drug therapy* / Q000453:epidemiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine