Efficacy of lamotrigine in idiopathic generalized epilepsy syndromes: a video-EEG-controlled, open study

Purpose: This prospective, open, video-EEG-controlled study examined the ef ficacy of lamotrigine (LTG) as add-on and monotherapy in idiopathic general ized epilepsy (IGE). Methods: 47 patients received LTG either because of insufficient seizure co ntrol (n = 35) or serious side effects of prior antiepileptic drugs (AED). Long term video-EEG recordings were performed before and after the introduc tion of LTC. The mean follow-up lime was 25.5 months. Results: Of 12 patients with refractory childhood absence epilepsy, 9 becam e seizure free; in one child with absences with eyelid myoclonia, absence f requency was reduced > 50%; in 2 children with absences with a mild atonic component, seizure reduction was only transient. Of 12 patients with juveni le absence epilepsy, 10 became seizure-free and, in 2, a > 50% reduction wa s obtained,ln 15 patients with juvenile myoclonic epilepsy, complete seizur e control was achieved in 7 patients, in 6 patients myoclonia persisted. In one patient generalized tonic-clonic seizures also persisted and another p atient developed a rash, LTG was therefore stopped. Of 5 patients with gran d-mat on awakening, 3 became seizure-free, and a reduction of > 50% was obt ained in one patient; LTC was stopped in one patient because of poor compli ance. Three patients with pure photosensitive epilepsy became seizure-free. At the end of the study, 11 patients were seizure-free on LTC monotherapy, and in most other patients concomitant AED dosage could be substantially r educed. Conclusions: Lamotrigine was effective and well tolerated in patients with various IGE syndromes, although differences were observed between individua l syndromes and seizure types.