Lennox-Gastaut syndrome

It is approved for treating atonic seizures in patients with Lennox-Gastaut syndrome and is effective for partial seizures as well. 

Topiramate, derived from D-fruc-tose, has complex, long-lasting anticonvulsant actions that cooperate to limit the spread of seizure activity it is effective in partial seizures and as an add-on in Lennox-Gastaut syndrome. 

Seizure disorder Alone or as an adjunct in the treatment of the Lennox-Gastaut syndrome (petit mal variant), akinetic, and myoclonic seizures. May be useful in patients with absence seizures (petit mal) who have failed to respond to succinimides (see Anticonvulsant section). 

Felbamate- Partial (adults) Partial/generalized assoc, with Lennox-Gastaut syndrome (children) 22 to 25 40% to 50% unchanged in urine 40% as unidentifie metabolites and conjugates... 

Epilepsy, adjunctive therapy Adjunctive therapy for partial seizures in adults with epilepsy and as adjunctive therapy in the generalized seizures of Lennox-Gastaut syndrome in pediatric (at least 2 years of age) and adult patients. 

Safety and efficacy in patients younger than 16 years of age, other than those with partial seizures and the generalized seizures of Lennox-Gastaut syndrome, have not been established. 

Children Lamotrigine is indicated as adjunctive therapy for partial seizures in patients above 2 years of age and for the generalized seizures of Lennox-Gastaut syndrome. Safety and efficacy for other uses in patients younger than 16 years of age have not been established. Safety and efficacy in patients below the age of 18 years with bipolar disorder have not been established. 

Seizures associated with Lennox-Gastaut syndrome - Adjunctive therapy in patients at least 2 years of age with seizures associated with Lennox-Gastaut syndrome. 

Adults (17 years of age and older) partial seizures, primary generalized tonic-clonic seizures, or Lennox-Gastaut syndrome-The recommended total daily dose as adjunctive therapy is 200 to 400 mg/day in 2 divided doses in adults with partial seizures, and 400 mg/day in 2 divided doses in adults with tonic-clonic seizures. It is recommended that therapy be initiated at 25 to 50... 

Felbamate, a new anticonvulsant, has beneficial effects in partial and secondarily generalized seizures.lt can reduce symptoms in Lennox-Gastaut syndrome. However an association with aplastic anemia reduces its usefulness and Lennox-Gastaut syndrome is considered to be its only indication. 

Glauser, T.A., Levisohn, P.M., Ritter, F., and Sachdeo, R.C. (2000) Topiramate in Lennox-Gastaut syndrome open-label treatment of patients completing a randomized controlled trial. Topiramate YL Study Group. Epilepsia 41 S86-S90. 

In spite of the seriousness of the adverse effects, thousands of patients worldwide remain on the medication. Usual dosages are 2000-4000 mg/d in adults, and effective plasma levels range from 30 mcg/mL to 100 mcg/mL. In addition to its usefulness in partial seizures, felbamate has proved effective against the seizures that occur in Lennox-Gastaut syndrome. 

Rufinamide is a new triazole derivative with little similarity to other antiseizure drugs. It is approved for use in Lennox-Gastaut syndrome and preliminary evidence suggests that it may also be useful in other difficult-to-treat epilepsy syndromes. 

Felbamate (FelbatolFelbamate is indicated for treatment of partial seizures in adults and children as well as generalized absence seizures (Lennox-Gastaut syndrome) in children. Felbamate appears to bind... 

Generic Name Felbamate Trade Name Felbatol Primary lndication(s) Used alone or as an adjunct in partial seizures in adults treatment adjunct in partial and generalized seizures associated with Lennox-Gastaut syndrome in children... 

Febrile seizures Idiopathic Lennox-Gastaut syndrome Absence seizures (petit mal)... 

Benzodiazepines used to treat epilepsy include diazepam, clonazepam, clobazam and lorazepam. Of these, diazepam and lorazepam have been most widely used to control status epilepticus, while use of clonazepam is usually restricted to the chronic treatment of severe mixed types of seizures (e.g. Lennox-Gastaut syndrome and infantile spasm). The major problem with most of the benzodiazepines, with the possible exception of clobazam, is sedation. 

Valproate is now the most commonly used antiepileptic drug worldwide. It is the drug of choice in primary generalized epilepsy, particularly in the treatment of generalized absence, myoclonus and tonic-clonic seizures. Valproate is the drug of first choice in atypical absence and atonic seizures, for Lennox-Gastaut syndrome and myoclonic epilepsy. 

Two premature neonates, who already had epileptic manifestations related to severe hypoxic ischemic encephalopathy, developed seizures (one tonic and the other tonic-clonic) within a few seconds of receiving intravenous midazolam (0.15 pg/kg) for sedation (25). In one, the seizure recurred after rechallenge on the same day. Benzodiazepines occasionally cause tonic seizures, especially after intravenous administration to children with Lennox-Gastaut syndrome. This seems to be the first report related to midazolam in newborns. 

In six patients with Lennox-Gastaut syndrome levetiracetam improved myoclonic, atonic, and generalized... 

De Los Reyes EC, Sharp GB, Williams JP, Hale SE. Levetiracetam in the treatment of Lennox-Gastaut syndrome. Pediatr Neurol 2004 30(4) 254-6. 

Generalized seizures of Lennox-Gastaut syndrome (adjunctive adults and children over age 2)... 

Seizures associated with Lennox-Gastaut Syndrome (2 years ot age or older)... 

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