title: Prophylactic antiepileptic treatment in Sturge-Weber disease.
abstract: OBJECTIVE
  In Sturge-Weber disease, motor and cognitive defects are supposed to result mostly from severe epilepsy. They might, therefore be partly prevented by prophylactic antiepileptic drug treatment. This condition constitutes a possible model for the study of prophylactic drug treatment in severe epilepsy. In the present study, we compared the outcome of patients treated prospectively with phenobarbitone before the first seizure, with those referred following the first seizure, in order to identify the issues related to the evaluation of prophylactic treatment of severe epilepsy.
  
  
  METHODS
  Motor and cognitive outcome were compared in patients treated prophylactically with phenobarbitone (16 cases) and in those treated following the first seizures (21 cases).
  
  
  RESULTS
  Whereas the incidence of motor deficit was similar in both groups (44 vs. 52%), that of mental retardation was lower in the group treated prophylactically (76.2 vs. 43.7%, P< 0.05). The major methodological issues encountered included the small number of patients identified at birth that could be included in the study, the need for randomization taking into account the size of the angioma, and the choice of the prophylactic medication, including the occurrence of epilepsy together with the course of motor and cognitive functions among the endpoints.
  
  
  CONCLUSIONS
  Prophylactic anti-epileptic drug treatment is worth considering for Sturge-Weber disease, but a randomized prospective study is necessary to determine this. It should be multicentric, take in account the size of the angioma, and decide what the most appropriate medication should be.
authors.affiliation: Department of Neuropaediatrics, Saint Vincent de Paul Hospital, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Ville
authors.forename: O
authors.initials: O
authors.lastname: Enjolras
authors.forename: C
authors.initials: C
authors.lastname: Chiron
authors.forename: O
authors.initials: O
authors.lastname: Dulac
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000627:therapeutic use*; D012640:Seizures / Q000517:prevention & control*; D012720:Severity of Illness Index; D013341:Sturge-Weber Syndrome / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010634:Phenobarbital