Besag Frank M C, Vasey Michael J, Brown Richard J
Child and Adolescent Mental Health Services, East London NHS Foundation Trust, Bedford, UK.
School of Pharmacy, University College London, London, UK.
Expert Rev Neurother. 2025 Jan;25(1):15-27. doi: 10.1080/14737175.2024.2439512. Epub 2024 Dec 21.
The seizures in Lennox-Gastaut syndrome are typically resistant to treatment. Seven antiseizure medications (ASMs) in the US (six in the UK/EU) are licensed for the treatment of seizures in LGS: lamotrigine, topiramate, rufinamide, clobazam, felbamate (not licensed in the UK/EU), cannabidiol and fenfluramine. Other options include neurostimulation, corpus callosotomy and dietary therapies, principally the ketogenic diet and its variants. New treatments and therapeutic strategies are needed to improve management of both seizures and cognitive/behavioral comorbidities in LGS.
Embase and Medline were searched for articles published between 1 January 2014 and 21 August 2024 reporting efficacy data for pharmacological, neurostimulation, surgical and dietary interventions in individuals with LGS focusing on recent advances. Ongoing and prospective studies were identified from the National Library of Medicine register of clinical trials.
LGS remains a difficult-to-treat epilepsy. Although no major breakthroughs have been reported, several established and novel ASMs, some surgical strategies and other treatment approaches are of benefit or are showing promise. Progress remains incremental but any improvements in the management of this resistant epilepsy syndrome are worthwhile.
伦诺克斯 - 加斯东综合征的癫痫发作通常对治疗具有抗性。在美国有七种抗癫痫药物（ASMs）（在英国/欧盟有六种）被批准用于治疗伦诺克斯 - 加斯东综合征的癫痫发作：拉莫三嗪、托吡酯、卢非酰胺、氯巴占、非氨酯（在英国/欧盟未获批准）、大麻二酚和芬氟拉明。其他选择包括神经刺激、胼胝体切开术和饮食疗法，主要是生酮饮食及其变体。需要新的治疗方法和治疗策略来改善伦诺克斯 - 加斯东综合征癫痫发作和认知/行为共病的管理。
检索了Embase和Medline数据库，以查找2014年1月1日至2024年8月21日期间发表的文章，这些文章报告了针对伦诺克斯 - 加斯东综合征患者的药物、神经刺激、手术和饮食干预的疗效数据，重点关注近期进展。从美国国立医学图书馆临床试验注册库中识别出正在进行的和前瞻性研究。
伦诺克斯 - 加斯东综合征仍然是一种难以治疗的癫痫。尽管尚未报道重大突破，但几种已确立的和新型抗癫痫药物、一些手术策略和其他治疗方法是有益的或显示出前景。进展仍然是渐进的，但对这种难治性癫痫综合征管理的任何改善都是值得的。
