[Vigabatrin: results with a new antiepileptic agents in 57 patients in a general neurological practice].

OBJECTIVE

To obtain answers to the following questions: can vigabatrin replace other anti-epileptics? Is it feasible to use VGB as a monotherapy?

DESIGN

Retrospective, descriptive.

SETTING

Neurological outpatient clinic of the Sophia Hospital in Zwolle, the Netherlands.

METHOD

In 57 of the 492 (28 men, 29 women) patients suffering from epilepsy who had been treated for more than 1 year, VGB (500-4000 mg/day) was added to the regimen because of persistent attacks (n = 21), adverse effects of other medication (n = 14) or both (n = 22). Mean age was 45 years (3-77). In the end, 17 patients were treated with VGB alone. The average frequencies of attacks and the adverse effects before and after start of VGB treatment were compared.

RESULTS

Almost all patients who had suffered from partial attacks became attack-free, as well as the majority of patients with generalised tonic-clonic attacks or a combination of these with partial attacks. In 5 patients from this group a status epilepticus occurred. The patients with infantile spasms became attack-free. Drowsiness and headache were the most frequent side-effects. Psychosis occurred in one patient. Eventually 11 of the 17 patients on VGB monotherapy became attack-free.

CONCLUSIONS

Adding VGB to the original AE, but also partial or full replacement of other AE by VGB in therapy-resistant epilepsy, can make a number of patients attack-free. This applies in particular to patients with partial epileptic attacks and infantile spasms.