Lamotrigine in typical absence epilepsy

Lamotrigine (LTG) is an anti-epileptic drug effective in partial seizures a nd generalized epilepsy. There is growing evidence of the usefulness of LTG in childhood (CAE) or juvenile (JAE) absences resistant to previous treatm ent. In this study all patients were identified using strict diagnostic cri teria and subdivided into two groups. (1) Eight patients affected by absenc e seizures resistant to valproic acid or ethosuximide, received LTG as an-a dd-on therapy, (2) seven patients affected by typical absence seizures not previously treated, received LTG monotherapy after the diagnosis. In the pa tients with resistant absence seizures, a full control of seizures was obta ined. In five of them, after a mean period of 12.5 months, the previous ant i-epileptic drugs were withdrawn leaving the patients on LTG monotherapy. I n one patient, absences relapsed and valproic acid was therefore added agai n to LTG to regain control of the seizures. In six of the seven patients on LTG monotherapy after the diagnosis, a full control of seizures was obtain ed. In the seventh patient the drug was stopped due to a skin rash. In conclusion LTG appears to be effective in resistant absence seizures in combination with valproic acid. Moreover, our preliminary data suggest that lamotrigine might be used as monotherapy in typical absence seizures. The advantages and disadvantages of LTG monotherapy in this type of epilepsy ar e discussed. (C) 1999 Elsevier Science B.V. All rights reserved.