title: [Long-term follow-up of childhood epilepsy treated with vigabatrin outside of clinical trials].
abstract: BACKGROUND
  Experimental conditions are not mirrored by clinical practice.
  
  
  OBJECTIVE
  To study the efficacy of vigabatrin in the usual conditions of everyday clinical practice.
  
  
  METHODS
  Retrospective review of all epileptic patients treated with vigabatrin in a neuropediatric outpatient clinic.
  
  
  METHODS
  a) Persistent seizure frequency reduction > or = 50%, and total control of seizures. Potential predictors of response were studied by logistic regression. b) Duration of VGB therapy, studied by the Kaplan-Meier method and its associated log-rank test.
  
  
  RESULTS
  113 patients with: partial symptomatic epilepsy (38%), partial cryptogenic (25.6%), partial idiopathic (6%), West syndrome (14%), Lennox-Gastaut syndrome (6%), other syndromes (9.7%). Reduction of seizure frequency was attained by 60% of patients at 3 months, sustained during 12 months by 40%, and during 5 years by 14%. Total control of seizures was present in 33% of patients at 3 months, persisted 12 months in 18% and 5 years in 2%. Independent predictors of a poor outcome were generalized seizures (except infantile spasms) and cerebral palsy, among others. The probability of continuing vigabatrin (VGB) therapy was 78% at 6 months, 55% at 2 years and 32% at 5 years. Duration of therapy was modified by early therapeutic response and antecedent of status epilepticus, among others. Adverse events were recorded in 18.5%. Visual fields were not studied in these series.
  
  
  CONCLUSIONS
  For the time being, VGB-treated patients belong to the difficult-to-treat group. Percentages of responders depend upon duration of follow-up.
authors.affiliation: Unidad de Neurología Infantil, Hospital de Cruces, Baracaldo, Vizcaya, España. cgaraizar@hcru.osakidetza.net
authors.forename: C
authors.initials: C
authors.lastname: Garaizar
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez-González
authors.forename: M A
authors.initials: MA
authors.lastname: Fernández-Cuesta
authors.forename: J M
authors.initials: JM
authors.lastname: Prats
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D020888:Vigabatrin / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D020888:Vigabatrin