Abstracts

Rationale: Recently, new anti-epileptic drugs have been introduced for intractable epilepsy syndromes including Lennox-Gastaut Syndrome (LGS). Among these is rufinamide, approved in November of 2008 for the adjunctive treatment of seizures in children 4 years or older, and adults. The objective of our study is to report our experience with rufinamide in a diverse patient population with LGS as well as other seizure disorders. Methods: A retrospective chart review was performed on patients treated with rufinamide at Stony Brook University Medical Center from 1/1/2007 to 6/16/2010. Data was gathered including patient background, dosing, length of use, seizure type and frequency, epilepsy syndrome, VNS usage and adverse events. Results: 33 patients were identified, 26 males and 7 females. Ages ranged from 3 to 52 years of age with 16 (48%) pediatric and 17 (52%) adults (>16 years old) with a mean age of 20 years. Mean dose was 28 mg/kg/day for the pediatric population and 1,483 mg/day for the adult population. Mean treatment duration was 332 days. All patients were on polypharmacy except for one. Number of other AEDs ranged from 0 to 6. Eight had a VNS implant. Indications for treatment were intractable epilepsy with poor seizure control. Seizures types were generalized tonic-clonic (26), atonic (9), myoclonic (11), partial (5), absence (5), juvenile myoclonic epilepsy (1), tonic (1), and infantile spasms (3). Seventeen met the criteria for LGS. Twenty-two patients (67%) experienced no adverse effects. Eleven patients (33%) experienced adverse effects necessitating discontinuation of rufinamide including anorexia (5), syncope (1), psychosis (1), headache (1), anxiety (1), and rash (1). One patient experienced a multi-organ system hypersensitivy reaction. There were no cases of SUDEP. Eighteen patients (55%) had improved seizure control during treatment. Although rufinamide is approved for LGS, we found a significant positive response in patients with other seizure disorders as well. EEGs before and during treatment were either unavailable for comparison or did not reveal unequivocal signs of electrographic improvement. Conclusions: Rufinamide is a relatively new anti-epileptic drug approved for LGS in patients 4 years of age and older. In our study, rufinamide was well tolerated and efficacious in LGS and diverse epilepsy syndromes.