Visual field constriction is not limited to children treated with vigabatrin

Vigabatrin (GVC) is widely used in the treatment of complex partial seizure s and infantile spasms. Persistent visual field constriction associated wit h GVG therapy in adults was reported as a rare but serious side-effect. Vis ual field examination in children is more difficult because of a lack of co operation among very young or mentally handicapped patients. We performed G oldmann perimetry in 12 of 153 patients treated with GVG as mono- or as add -on therapy. The others would not cooperate, and two adolescents refused th e examination. For comparison, we examined 12 age-matched patients with com plex partial or generalized epilepsy who had never taken GVG. In five of 12 GVG-treated patients, and in one of the control group, we fou nd a concentric visual field constriction. All patients were subjectively a symptomatic. The GVG-treated patients had taken the drug in combination wit h valproic acid (VPA) or oxcarbazepine (OCB). In four patients, GVG treatme nt was already stopped at the time of the ophthalmologic examination. Three patients had intracerebral lesions that could not account for the patholog ic perimetric findings. The single patient from the control group with conc entric visual field constriction had an absence epilepsy, treatment being p erformed with VPA and lamotrigine (LTG). In conclusion, GVG has a causal hut not unique connection with visual field constriction in pediatric patients.