title: [The effects of lamotrigine on refractory epilepsies in persons with severe motor and intellectual disabilities].
abstract: OBJECTIVE
  We studied the effects and tolerability of lamotrigine (LTG) on refractory epilepsies in persons with severe motor and intellectual disabilities (SMID).
  
  
  METHODS
  We introduced LTG to 40 subjects all who were severely retarded and suffered from symptomatic epilepsies consisting of six cases of generalized epilepsy (GE), 33 of partial epilepsy (PE), and one of unclassified epilepsy (according to the 1989 ILAE classification standards). We evaluated the efficacy of LTG in seizure reduction and its tolerability for persons with SMID.
  
  
  RESULTS
  Following treatment, 83% of GE and 42% of PE cases showed a 50% reduction in seizure frequency. From the seizures observed in our study cohort, a response rate (RR) with an over 50% reduction was found in 54% of secondarily generalized tonic-clonic (n = 24), 30% of complex partial (n = 18), and 25% of myoclonic seizures (n = 16). As for adverse effects, nine subjects (22.5%) experienced sleep problems, six subjects (15%) experienced excitement mainly during night-time, and four cases each (10%) experienced involuntary movements and sleepiness. As for additional effects on patients' quality of life (QOL), even in poor responder (< 50% RR) patients, LTG improved "alertness" in six cases, improved "activity of daily life" in four cases, and helped to diminish "appetite loss" in three cases.
  
  
  CONCLUSIONS
  LTG therapy for epileptic conditions in persons with SMID has potential for not only reducing seizure frequency, but also for improving QOL.
authors.affiliation: Department of Pediatrics, Kakogawa Hospital Organization, Kakogawa West-City Hospital, Kakogawa, Hyogo. ama-p@rc4.so-net.ne.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Adachi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kawasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000188:drug therapy*; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine