Outcomes in treatment of Adults with Lennox-Gastaut Syndrome
Abstract number :
2.200
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2017
Submission ID :
349513
Source :
www.aesnet.org
Presentation date :
12/3/2017 3:07:12 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Eugene Ramsay, Ochsner Medical Center; Uma Menon, Ochsner Medical Center; Michael Pepper, Ochsner Medical Center; Neil Billeaud, Ochsner Medical Center; and Fawad A. Khan, Ochsner Medical Center
Rationale: Evaluate outcomes in patients with Lennox-Gastaut Syndrome (LGS) Methods: IRB approved retrospective chart review of 44 patients with LGS at Ochsner epilepsy clinic during 2010 – 2016, with follow-up period ranging 1 – 6 years. Results: Demographics were 33 males and 11 females; age range of 2 months - 18 years. Etiology was unknown in 33 (75 %) and known in 11 (25%) and include tuberous sclerosis (3), encephalitis (2), cerebral palsy (3), traumatic brain injury (2) and cardiac arrest (1). Seizure outcome was 1) Controlled in 10 (37%), 2) improved by 40--90% reduction in 17 (38.6%) and 3) no change in seizure frequency in 8 (18%) and 4) worse in 4 (9.1%). There were 3 deaths with etiology being SUDEP in 1 patient after being seizure-free for more than 7 months, sepsis in 1 patient and SE in patient at initial encounter when admitted in SE. Four patients were lost to follow-up.AEDs discontinued after initial visit and the resulting outcomes (Table 1)VNS was present in 9 patients at initial visit and 7 were added during the period of review. Seizure control improved in 42.9% (3/7) patients who had VNS added. 2 patients with VNS present at initial encounter became seizure-free with the addition of Clobazam (and Rufinamide in one patient). 4 patients had worsening (1 death included occurred during 1st encounter) seizure control. 41% (18/44) had Levetiracetam on initial encounter and was discontinued in 89% (16/18).63% (10/16) had improved seizure control and 25% (4/16) became seizure-free after Levetiracetam was discontinued. 1 patient became seizure-free on Levetiracetam with the addition of Lamotrigine. (Table 2) Conclusions: 61.4% improvement in seizure control with 37% seizure freedom was attained with AEDs including Clobazam, Lamotrigine, Vigabatrin and Rufinamide. Some benefit was also noted with the addition of VNS. Improved seizure control was found in patients in which levetiracetam (63%) and carbamazepine (71%). The finding suggest improved control in LGS can be realized by selecting some AEDs and elimination of other AEDs. Funding: None
Clinical Epilepsy