Abstracts

Rationale: Rufinamide is a triazole derivative, a novel antiepileptic drug (AED)which has been found to be effective in the treatment of drop attacks and partial seizures associated to Lennox - Gastaut Syndrome. Nevertheless efficacy of Rufinamide was demonstrated in five randomized placebo-controlled trials in patients with partial seizures. The aim of the study was to explore the efficacy of rufinamide as a second line adjunctive treatment of partial seizures in adult with focal epilepsy. We aimed to describe a group of 10 patients with focal epilepsy who showed drug resistance to classic second line antiepileptic drugs. Methods: This study was carried out in our Epilepsy Center. We describe 10 adults patients (mean age 14,5) with focal epilepsy , who developed drug resistant epilepsy. Diagnosis of epilepsy was made according to the Commission on Classification and terminology of the International League against Epilepsy . Patients were interviewed, and general and neurological physical examination was performed. All underwent to prolonged awake and sleep polygraphic video-electroenecephalography study and high quality brain MRI. Initial dosage and titration of Rufinamide were at discretion of epileptologist according to medical need and considering changes in the pharmacokinetics associated to concomitants AED. Efficacy was evaluated by comparing the frequency of countable seizures at baseline ( 4 weeks before add-on of Rufinamide) with the frequency in the last 8 weeks of observation. Results: six /ten patients were responders . Four patients experienced a greater 65% seizure reduction. Two patients showed a 25% seizure reduction , three of them not showed modifications in seizures frequency and one showed a gather reduction , but no frequency reduction. Conclusions: Responder rates for patients with partial seizures was around 23% in the current opinions. But the patient population examined in previous literature showed mostly severe drug resistant epilepsy. Our sample, althought small, was selected basing on epilepsy resistance to two first line AED drugs. This data address us to puzzle that Rufinamide used as off-label treatment in not severely affected drug-resistance epilepsy showed higher responder rate , ranging from 25 to 65%of seizures reduction. Further study are required to clearly define patient population that could benefit by Rufinamide