[Efficacy and tolerability of vigabatrin in West syndrome].
West syndrome (WS) is a severe epileptic encephalopathy of childhood, characterized by spasms, developmental deterioration and hipsarhythymia.


OBJECTIVE
To evaluate the safety and efficacy of vigabatrin (VGB) in the treatment of WS.


METHODS
We evaluated every patient diagnosed with WS seen at the pediatric epilepsy clinic and exposed to VGB. Patients were interviewed according to a semistructured questionnaire and we analyzed gender, age, etiology (cryptogenic or symptomatic), associated diseases, age of seizure onset, neuroimaging findings, EEG prior and after VGB, use of other antiepileptic drugs, time for seizure control, electroretinogram, visual complaints, adverse events and family history of epilepsy.


RESULTS
Twenty-three patients were evaluated, 16 boys, ages ranging from 1.25 years to 11.5 years (mean=5y3m). Sixteen (69.5%) patients were seizure free, five (22%) had partial seizure control and in two (8.5%) there was no improvement. Only one patient presented gabaergic retinopathy. Six (26%) patients presented adverse events: somnolence, aggressivity or retinopathy. Patients with seizure onset after 6 months of age presented better results after VGB introduction (p<0.05). There was no difference in seizure control according to duration of epilepsy before VGB treatment or etiology of the seizures (p>0.05). After VGB, no patient presented hipsarrhythymia and 50% had a normal EEG.


CONCLUSIONS
Although VGB may be associated with serious adverse events such as gabaergic retinopathy, our results show that it should be considered in the treatment of WS.
Moraes
Maria Helena P
MH
Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estudual de Campinas, Campinas, SP, Brasil.
Montenegro
Maria Augusta
MA
Franzon
Renata C
RC
Avila
José O
JO
Guerreiro
Marilisa M
MM
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018682:GABA Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D012164:Retinal Diseases / Q000139:chemically induced; D013036:Spasms, Infantile / Q000188:drug therapy*; D016896:Treatment Outcome; D020888:Vigabatrin / Q000009:adverse effects / Q000627:therapeutic use*; D014794:Visual Fields / Q000187:drug effects
D000927:Anticonvulsants; D018682:GABA Agents; D020888:Vigabatrin