Prospective study of first-line vigabatrin monotherapy in childhood partial epilepsies

This was a prospective open comparative pilot study to assess the efficacy and tolerability of first-line vigabatrin monotherapy in childhood partial epilepsies. Two groups of patients were recruited over the same period. The vigabatrin monotherapy group comprised 40 patients (18 male, 22 female; me an age at last visit 7.5 years); the comparative carbamazepine monotherapy group comprised 40 consecutive clinic patients (22 male, 18 female; mean ag e at last visit 7.8 years). Seizures disappeared in 82% of vigabatrin patie nts and in all carbamazepine patients with idiopathic partial epilepsy, and in 50% of vigabatrin patients and 55% of carbamazepine patients with sympt omatic partial epilepsy. Interictal EEG abnormalities decreased in vigabatr in patients more than in carbamazepine patients (P < 0.05). Tolerability wa s good in vigabatrin patients, but four out of 37 showed mild irritability by the end of the trial. Persistent sedation was observed in eight of the 4 0 patients receiving carbamazepine. No patient had drug therapy discontinue d because of side-effects. During vigabatrin long-term monotherapy, efficac y and good clinical tolerability were maintained. These results suggest tha t vigabatrin may be an alternative first-line treatment for childhood parti al epilepsies. Further blinded comparative randomized trials are needed. (C ) 1999 Elsevier Science B.V. All rights reserved.