[Vigabatrin in the treatment of intractable focal epilepsy in children and adolescents. Two-year study].
Vigabatrin VGB is the drug of III generation applied for a long time to patients in Poland. In Polish literature there were many reports published concerning the efficacy of VGB, however, most are short-term examinations. The AIM OF THE STUDY WAS: 1. the analysis of VGB efficacy in long term treatment of intractable focal epilepsies in children and adolescents; 2. stating if efficacy of VGB treatment depends on localization of epileptic focus; 3. answering if the effect of tolerance is developed in relation to VGB.


METHODS
There were 50 patients between 4 to 20 years of age (average 12.7 +/- 4.8) with intractable focal epilepsy in the examined group. partial complex seizures were the dominant type of seizures at 74% of the examined patients. Time of observation amounted to 24 months. The patients were administered with VGB as add-on therapy. 37 patients (74%) were diagnosed with temporal lobe epilepsy, 11 (22%) with frontal lobe epilepsy, 1 patient (2%) with parietal lobe epilepsy and 1 (2%) with occipital lobe epilepsy. Patients who did not complain of seizures for a period of at least one year were classified as those with "seizure free".


RESULTS
The examination was completed for 36 patients (76%). The treatment was discontinued in 12 patients (24%) as there was not a sufficient seizure control. One patient with temporal lobe epilepsy stopped the drug as three occurred the epileptic state of atypic generalised absence seizures induced by VGB. The final evaluation comprised all 50 examined patients. 9 patients (18%) achieved complete seizure control, 24 (48%) reduction to 50-99%. There was no change in 17 patients (34%). The examined patients with frontal localisation of epileptic focus presented significantly worse results of treatment, i.e. (reduction in the number of seizures over 35.3-36.5%) than the patients with temporal lobe epilepsy (reduction over 63.8 +/- 37.2%--p < 0.001). No significant difference in the average number of seizures in the 5th and 24th month of treatment was reported in the whole examined group. This contradicts the existence of the effect of tolerance in relation to VGB.


CONCLUSIONS
1. Vigabatrin is a very efficient drug in long-term treatment of patients with intractable focal epilepsies. 2. Patients with temporal lobe epilepsy present statistically better treatment results than patients with frontal lobe epilepsy. 3. No effect of tolerance to VGB was recorded during a 2-year observation.
Kozik
A
A
Oddział Neurologii Dzieciecej Szpitala im. T. Marciniaka we Wrocławiu.
Ujma-Czapska
B
B
Grotowska
M
M
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020888:Vigabatrin / Q000627:therapeutic use*
D000927:Anticonvulsants; D020888:Vigabatrin