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Previous Volume 337:1807-1812 December 18, 1997 Number 25 Next

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ABSTRACT

Background The Lennox–Gastaut syndrome, a severe form of epilepsy that usually begins in early childhood, is difficult to treat. Dose-related drug toxicity is common.

Methods We conducted a double-blind, placebo-controlled trial of the antiepileptic drug lamotrigine in patients with the Lennox–Gastaut syndrome. Eligible patients had more than one type of predominantly generalized seizure, including tonic–clonic, atonic, tonic, and major myoclonic, and had seizures on average at least every other day. After a 4-week base-line period in which all participants received placebo, we randomly assigned 169 patients (age range, 3 to 25 years) to 16 weeks of lamotrigine (n = 79) or placebo (n = 90) in addition to their other antiepileptic drugs.

Results The median frequency of all major seizures changed from base-line levels of 16.4 and 13.5 per week in the lamotrigine and placebo groups, respectively, to 9.9 and 14.2 per week after 16 weeks of treatment (P = 0.002). Thirty-three percent of the patients in the lamotrigine group and 16 percent of those in the placebo group had a reduction of at least 50 percent in the frequency of seizures (P = 0.01). There were no significant differences between groups in the incidence of adverse events, except for colds or viral illnesses, which were more common in the lamotrigine group (P = 0.05).

Conclusions Lamotrigine was an effective and well-tolerated treatment for seizures associated with the Lennox–Gastaut syndrome.

Source Information

From the American Memorial Hospital, Hôpital d'Enfants, Reims, France (J.M.); the Department of Neurology, Comprehensive Epilepsy Center, University of Kentucky College of Medicine, Lexington (E.T.); the Pediatric Clinic, Central County Hospital Ryhov, Jonkoping, Sweden (J.F.V.A.); Infantil Virgen del Rocio Hospital, Seville, Spain (M.N.B.); Central Nervous System Clinical Research, Glaxo Wellcome Research and Development, Greenford, Middlesex, United Kingdom (E.L.M.); and Central Nervous System Clinical Research, Glaxo Wellcome Research and Development, Research Triangle Park, N.C. (P.M.).

Address reprint requests to Dr. Trevathan at the Comprehensive Epilepsy Center, University of Kentucky College of Medicine, Kentucky Clinic L445, Lexington, KY 40536-0284.

Full Text of this Article

Related Letters:

Lamotrigine for Generalized Seizures Associated with the Lennox–Gastaut Syndrome
Trevathan E., Mullens E. L., Manasco P.
Extract | Full Text  
N Engl J Med 1998; 339:851-852, Sep 17, 1998. Correspondence

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