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ETP06 A new method of raising LTG dose
Abstracts: Poster Presentations, the Seventh European Paediatric Neurology Society (EPNS) Congress to determine the efficacy of OXC in pediatric patients with sleep activated discharges on EEG. Methods: Patients followed-up at least three months at Hacettepe University department of Pediatric Neurology with diagnosis of epilepsy and sleep activated discharges on EEG were included in the study. Oxcarbazepine treatment was started either as monotherapy or adjunctive therapy. Results: Of 27 patients, 10 were boys, 17 were girls. Mean age of the patients was 8.7±0.5 years. After three months, 25.9% of the patients (7/27) had 50% decrease and 22.2% (6/27) had an increase in the seizure frequency. Of available 25 EEGs, 36% showed improvement of the epileptiform abnormalities, 48% had no change and 16% had worsening of the epileptiform abnormalities compared to pretreatment EEGs. At 12 months, of 18 EEGs, 11.1% had improvement, 38.9% had worsening and at 24 months of 11 EEGs, only 9.1% had improvement, 9.1% had worsening and 81.8% had no change on EEG. Conclusion: To determine the efficacy of OXC in children with sleep activated discharges on EEG, more studies with larger populations are warrented. ETP05 Probable age-association of the Lamotrigine effect in atypical rolandic epilepsy P. Dimova *, V. Bojinova. Clinic of Child Neurology and 2EEG Laboratory, St. Naum University Hospital of Neurology and Psychiatry, Sofia, Bulgaria The aim of the study is to evaluate the clinical and electroencephalographic (EEG) features of children with atypical rolandic epilepsy showing different response to addon Lamotrigine (LTG) treatment. Ten cases with frequent seizures, drug-resistance and impairment of behavior and/or neuropsychological development, were treated with LTG. According to the clinical effect observed two subgroups were formed: children with an excellent response (n = 4) and children with an aggravation (n = 6). The medical charts and EEG records of the two subgroups before and during the LTG treatment were reviewed and analyzed, and a comparison between groups has been made. Both subgroups did not differ in terms of their main clinical and EEG characteristics. The only difference established was the age of epilepsy onset: in all children aggravated from LTG the seizures started at the age of 2 to 3 years, while the children who benefited from this anticonvulsant experienced the first seizure at an older age (3 to 9 years). No EEG criteria were found to be predictive for a complicated disease course following LTG add-on therapy. LTG could have opposite effects in treating complicated rolandic epilepsy. An electroclinical aggravation is more likely to be expected in younger children with an earlier epilepsy onset.
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first sign of rash was evident, moment when we returned at the previous dose and interval and gave antihistaminic therapy for 3−5 days. Control group consists of 26 patients 2 to 13 years old, with similar diagnosis with study group. These patients received LTG starting with 0.3 mg/kg/day and raised with the same dose at 2 weeks intervals. Results: In the study group, 3 patients reached a 3 days raising doses interval, 4 patients a 5 days interval, 2 patients a 6 days interval, 8 patients a 7 days interval and 2 patients at 8 days interval. The 3 patients that reached a 3 days interval didn’t show rash. Eruption was mild in all patients and disappeared in 1−3 days with antihistaminic treatment. In the control group, 1 patient presented serious rash after the first 0.3 mg/kg/day LTG dose and he was withdrawn from study because idiosyncratic reaction. After therapeutic dose was reached, patients from both groups showed similar efficacy results and no rash. Conclusions: Starting from the results of this study we suggest that this method of introducing LTG at intervals progressively decreased from 2 weeks to seven days could be a safe and faster way of reaching therapeutic levels in children. ETP07 The efficacy of topiramate as an additional drug therapy in childhood epilepsy: a long term clinical experience A. Unalp *, N. Uran, T. Hizli. Behcet Uz Child Disease and Pediatric Surgery Education and Research Hospital, Izmir, Turkey Purpose: In this study, we evaluated the initial and long-term efficacy of topiramate as an additional drug therapy for cases which were followed with the diagnosis of resistant epilepsy. Methods: Seventy one patients (mean age 8.83 years; 2−18 years) who had been using TMP for at least 1 year were included in this study designed as retrospective, openlabel and add-on study, between 2003 and 2007 in Behcet Uz Children’s Hospital. Results: Twenty seven patients were followed up after diagnosis of generalized epilepsy and 44 patients were followed up after diagnosis of partial epilepsy. 51 patients (71.8%) showed good response to initial treatment, and in 33.8% of the patients a complete seizure control was achieved. The retention at a mean of 32 months was 41 of the 71 patients (57.7%); 18 patients (25.3%) were seizure free. A loss of efficacy in long-term use occurred in 20 of 51 initial responders (39.2%). The drug was determined to be more effective in partial epilepsies compared to generalized epilepsies (77.2%, 62.9%, respectively). As a result, in long term follow up in refractory epilepsies, it was determined that TPM may be discontinued, and the drug was more effective on partial epilepsies.
ETP06 A new method of raising LTG dose
ETP08 Topamax in childhood epilepsy management
D. Craiu *, S. Magureanu. Carol Davila University of Medicine, Pediatric Neurology Clinic, Al. Obregia Hospital, Bucharest, Romania
V. Zykov, O. Milovanova, I. Stepanischev, F. Tikhomirova, I. Tambiev, A. Belaya, N. Narcia. Russian Medical Academy of Postgraduate Education, Turkey
Introduction: It is well known that Lamotrigine (LTG) is an antiepileptic drug (AED) with a high efficacy against seizures, but requiring a long period of time for raising dose until therapeutic levels are reached. There is a risk of allergic rash if LTG is too rapidly introduced or too large doses are used. Purpose: The aim of our study was to define a new, shorter way of raising LTG until therapeutic levels are reached, keeping the safety and efficacy items untouched. Methods: This is an open-label study. An informed consent was signed by one parent of each patient enrolled. The working group consists of 19 patients aged 2 to 12 years who received LTG starting with 0.3 mg/kg/day and raised with the same dose at intervals progressively decreased. We stopped decreasing interval at minimum 3 days or when the
Purpose: To evaluate efficacy of topiromate (Topamax) in childhood epilepsy treatment. Method: Total 12 patients (six girls 3−15 years, and 4 boys 2−10 years old) suffering from different epilepsy forms 5 cases, idiopatic generalized (idiopatic partial forms 1 case, cryptogenic partial form 3 cases, symptomatic partial form 3 cases) were examined and treated. In all patients complex clinico-instrumental examination was performed, including routine EEG before treatment initiation, during dose titration (1−2 months) and after dose titration (2 months). Routine blood analysis, biochemical blood analysis, urine analysis, US-investigation, CT, skull MRT were performed. Results: Topiromate monotherapy was performed in 12 patients. Before topiromate treatment 6 patients received other
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first sign of rash was evident, moment when we returned at the previous dose and interval and gave antihistaminic therapy for 3−5 days. Control group consists of 26 patients 2 to 13 years old, with similar diagnosis with study group. These patients received LTG starting with 0.3 mg/kg/day and raised with the same dose at 2 weeks intervals. Results: In the study group, 3 patients reached a 3 days raising doses interval, 4 patients a 5 days interval, 2 patients a 6 days interval, 8 patients a 7 days interval and 2 patients at 8 days interval. The 3 patients that reached a 3 days interval didn’t show rash. Eruption was mild in all patients and disappeared in 1−3 days with antihistaminic treatment. In the control group, 1 patient presented serious rash after the first 0.3 mg/kg/day LTG dose and he was withdrawn from study because idiosyncratic reaction. After therapeutic dose was reached, patients from both groups showed similar efficacy results and no rash. Conclusions: Starting from the results of this study we suggest that this method of introducing LTG at intervals progressively decreased from 2 weeks to seven days could be a safe and faster way of reaching therapeutic levels in children. ETP07 The efficacy of topiramate as an additional drug therapy in childhood epilepsy: a long term clinical experience A. Unalp *, N. Uran, T. Hizli. Behcet Uz Child Disease and Pediatric Surgery Education and Research Hospital, Izmir, Turkey Purpose: In this study, we evaluated the initial and long-term efficacy of topiramate as an additional drug therapy for cases which were followed with the diagnosis of resistant epilepsy. Methods: Seventy one patients (mean age 8.83 years; 2−18 years) who had been using TMP for at least 1 year were included in this study designed as retrospective, openlabel and add-on study, between 2003 and 2007 in Behcet Uz Children’s Hospital. Results: Twenty seven patients were followed up after diagnosis of generalized epilepsy and 44 patients were followed up after diagnosis of partial epilepsy. 51 patients (71.8%) showed good response to initial treatment, and in 33.8% of the patients a complete seizure control was achieved. The retention at a mean of 32 months was 41 of the 71 patients (57.7%); 18 patients (25.3%) were seizure free. A loss of efficacy in long-term use occurred in 20 of 51 initial responders (39.2%). The drug was determined to be more effective in partial epilepsies compared to generalized epilepsies (77.2%, 62.9%, respectively). As a result, in long term follow up in refractory epilepsies, it was determined that TPM may be discontinued, and the drug was more effective on partial epilepsies.
ETP06 A new method of raising LTG dose
ETP08 Topamax in childhood epilepsy management
D. Craiu *, S. Magureanu. Carol Davila University of Medicine, Pediatric Neurology Clinic, Al. Obregia Hospital, Bucharest, Romania
V. Zykov, O. Milovanova, I. Stepanischev, F. Tikhomirova, I. Tambiev, A. Belaya, N. Narcia. Russian Medical Academy of Postgraduate Education, Turkey
Introduction: It is well known that Lamotrigine (LTG) is an antiepileptic drug (AED) with a high efficacy against seizures, but requiring a long period of time for raising dose until therapeutic levels are reached. There is a risk of allergic rash if LTG is too rapidly introduced or too large doses are used. Purpose: The aim of our study was to define a new, shorter way of raising LTG until therapeutic levels are reached, keeping the safety and efficacy items untouched. Methods: This is an open-label study. An informed consent was signed by one parent of each patient enrolled. The working group consists of 19 patients aged 2 to 12 years who received LTG starting with 0.3 mg/kg/day and raised with the same dose at intervals progressively decreased. We stopped decreasing interval at minimum 3 days or when the
Purpose: To evaluate efficacy of topiromate (Topamax) in childhood epilepsy treatment. Method: Total 12 patients (six girls 3−15 years, and 4 boys 2−10 years old) suffering from different epilepsy forms 5 cases, idiopatic generalized (idiopatic partial forms 1 case, cryptogenic partial form 3 cases, symptomatic partial form 3 cases) were examined and treated. In all patients complex clinico-instrumental examination was performed, including routine EEG before treatment initiation, during dose titration (1−2 months) and after dose titration (2 months). Routine blood analysis, biochemical blood analysis, urine analysis, US-investigation, CT, skull MRT were performed. Results: Topiromate monotherapy was performed in 12 patients. Before topiromate treatment 6 patients received other