The effect of tiagabine on spasticity in children with intractable epilepsy: A pilot study

Preliminary pharmacologic evidence suggests that tiagabine, a new presynapt ic gamma-aminobutyric acid-uptake inhibitor developed as an antiepileptic d rug, may also relieve spasticity. This pilot study assessed the drug's effi cacy in 14 children with congenital or acquired spastic quadriplegia and co ncomitant intractable epilepsy refractory to treatment with multiple antiep ileptic drugs. The primary outcome variable was change in motor function; t he secondary outcome was change in seizure frequency. Tiagabine was initiat ed at 0.1-0.2 mg/kg/day and then gradually titrated upward until seizures c eased, adverse effects supervened, or the maximum dose of 1.1 mg/kg/day,vas reached. When a modified Ashworth scale was used to assess motor function, a mean improvement of approximately 50% was observed. Common findings incl uded improved tone, strength, coordination, range of motion, and relaxation of extremities, with less ataxia and wobbling, Mean reduction in seizure f requency was 50-74%. Randomized, double-blind controlled studies are needed to confirm the suggested efficacy of tiagabine in relieving chronic spasti city in children with neurodevelopmental disorders. (C) 1999 by Elsevier Sc ience Inc. All rights reserved.