Acute encephalopathy associated with vigabatrin in a six-month-old girl

Purpose: Vigabatrin (VGB) is a new-generation anticonvulsant used in the tr eatment of partial seizures and West syndrome. Side effects of VGB treatmen t in adults and children are well described. Acute encephalopathy with VGB has recently been reported in eight adults. They developed stupor, confusio n, and electroencephalographic abnormalities after starting VGB. Does the a cute encephalopathy with VGB also occur in childhood? Methods: We describe a B-month-old girl with infantile Alexander disease wi th hydrocephalus who developed similar clinical symptoms with apathia, somn olence, and sopor, as well as slowing of the background activity in EEG, 3 days after starting VGB. After exclusion of shunt dysfunction, encephalitis , metabolic dysfunction, and renal failure, VGB was discontinued. Results. During the next 2 days, symptoms subsided, and after 10 days, EEG background activity returned to the one before starting VGB. Conclusions: Acute encephalopathy associated with VGB in children seems to be very rare, but should not be ignored.