title: Adjunctive Madopar for ultrarefractory epilepsy? Preliminary observations.
abstract: BACKGROUND
  The optimum drug treatment for ultrarefractory epilepsy after failure of seven prior antiepileptic drugs (AEDs) remains uncertain. Prompted by reports that adjunctive amantadine or l-dopa has been useful for children with refractory absence seizures and Lennox-Gastaut syndrome, we studied the utility of dopaminergic agents for adults with ultrarefractory epilepsy.
  
  
  METHODS
  We assessed seizure control following adjunctive treatment for up to 12 months with the dopaminergic agent Madopar© in three adult patients with ultrarefractory epilepsy following brain injury or with Lennox-Gastaut syndrome, who had not achieved sustained seizure remission during past treatment with at least seven lifetime AEDs.
  
  
  RESULTS
  The adjunctive use of Madopar was associated with a reduction or remission of tonic-clonic seizures in two patients. However, Madopar seemed to have aggravated absence seizures in the patient with Lennox-Gastaut syndrome.
  
  
  CONCLUSIONS
  Although our preliminary observations do not and cannot establish the efficacy or safety of adjunctive Madopar, it may be an option for treatment of ultrarefractory focal seizures in adults if confirmed by randomized controlled trials.
authors.affiliation: Department for Psychophysiology and Organic Mental Disorders, University Psychiatric Clinic Vrapce, Zagreb, Croatia.
authors.forename: Danilo
authors.initials: D
authors.lastname: Hodoba
authors.forename: Ana Marija
authors.initials: AM
authors.lastname: Santic
authors.forename: Dieter
authors.initials: D
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001545:Benserazide / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy; D065768:Lennox Gastaut Syndrome; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D013036:Spasms, Infantile / Q000188:drug therapy
chemical_list: D000927:Anticonvulsants; D004338:Drug Combinations; D004791:Enzyme Inhibitors; C005177:benserazide, levodopa drug combination; D007980:Levodopa; D001545:Benserazide