[Effectiveness of vigabatrin in west syndrome associated with tuberous sclerosis].
Naoki Ando, Shinji Fujimoto, Tatsuya Ishikawa, Satoru Kobayashi, Ayako Hattori, Tetsuya Ito, Hajime Togari
Abstract
Naoki Ando, Shinji Fujimoto, Tatsuya Ishikawa, Satoru Kobayashi, Ayako Hattori, Tetsuya Ito, Hajime Togari
Abstract
Vigabatrin (VGB) is one of the most effective anti-epileptic drugs for tonic spasms, those accompanied with tuberous sclerosis complex (TSC), but is not available in Japan. We treated 7 patients with West syndrome (WS) and TSC with VGB. In these patients, VGB treatment was started at 5-65 months of age. Six patients (86%) had complete cessation of tonic spasms. Of these, 3 patients had complete cessation within 24 hours after VGB treatment. The mean initial dosage of VGB was 36.2 mg x kg(-1) x day(-1), and the mean maintenance dosage was 38.4 mg x kg(-1) x day(-1). At the beginning of VGB treatment, 3 patients had hypsarrhythmia, 2 had focal discharge with generalization, and 2 had only focal discharge on electroencephalography. Hypsarrhythmia disappeared within 4-8 weeks after VGB treatment. Behavioral problems and sleep difficulty were observed in 6 patients. Visual field examination revealed no abnormalities in 3 patients. We hope that patients with WS and TSC can be treated with VGB as soon as possible in Japan.
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Vigabatrin (VGB) is one of the most effective anti-epileptic drugs for tonic spasms, those accompanied with tuberous sclerosis complex (TSC), but is not available in Japan. We treated 7 patients with West syndrome (WS) and TSC with VGB. In these patients, VGB treatment was started at 5-65 months of age. Six patients (86%) had complete cessation of tonic spasms. Of these, 3 patients had complete cessation within 24 hours after VGB treatment. The mean initial dosage of VGB was 36.2 mg x kg(-1) x day(-1), and the mean maintenance dosage was 38.4 mg x kg(-1) x day(-1). At the beginning of VGB treatment, 3 patients had hypsarrhythmia, 2 had focal discharge with generalization, and 2 had only focal discharge on electroencephalography. Hypsarrhythmia disappeared within 4-8 weeks after VGB treatment. Behavioral problems and sleep difficulty were observed in 6 patients. Visual field examination revealed no abnormalities in 3 patients. We hope that patients with WS and TSC can be treated with VGB as soon as possible in Japan.
Key concepts: Vigabatrin, Hypsarrhythmia, Tuberous sclerosis, West Syndrome, Medicine, Tonic (physiology), Epilepsy, Pediatrics