Lamotrigine for startle-induced seizures

Startle-induced seizures are reflex seizures precipitated by a sudden, surp rising stimulus, usually auditory. Aetiologies, electroencephalographic cor relates, and brain structural abnormalities are variable. Because of the fr equent tonic component at onset, falling is a major clinical problem. There is no established drug of choice, and therapy is often unsatisfactory. Adj unctive lamotrigine therapy was used in four consecutive patients with this syndrome seen in a referral epilepsy practice. All four had been refractor y to virtually every other drug, but responded dramatically to lamotrigine with elimination of falls from seizures. This observation may serve as pilo t data for trials of lamotrigine for startle-induced or other varieties of reflex epilepsies, as adjunctive or monotherapy. (C) 1999 BEA Trading Ltd.