Proposed anti-seizure medication combinations with rufinamide in the treatment of Lennox-Gastaut syndrome: Narrative review and expert opinion.

Autor: Sankar R; Departments of Neurology and Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA; UCLA Mattel Children's Hospital, Los Angeles, CA, USA. Electronic address: RSankar@ucla.edu., Chez M; Sutter Health, Roseville, CA, USA; California Northstate University School of Medicine, Elk Grove, CA, USA., Pina-Garza JE; The Children's Hospital at TriStar Centennial, Nashville, TN, USA., Dixon-Salazar T; Lennox-Gastaut Syndrome Foundation, San Diego, CA, USA., Flamini JR; PANDA Neurology, Atlanta, GA, USA., Hyslop A; Stanford University School of Medicine, Palo Alto, CA, USA., McGoldrick P; Boston Children's Health Physicians, Valhalla, NY, USA; Maria Fareri Children's Hospital, Valhalla, NY, USA; New York Medical College, Valhalla, NY, USA., Millichap JJ; Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Resnick T; Nicklaus Children's Hospital, Miami, FL, USA., Rho JM; Departments of Neurosciences, Pediatrics & Pharmacology, University of California San Diego and Rady Children's Hospital, San Diego, CA, USA., Wolf S; Boston Children's Health Physicians, Valhalla, NY, USA; Maria Fareri Children's Hospital, Valhalla, NY, USA; New York Medical College, Valhalla, NY, USA.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2023 Aug; Vol. 110, pp. 42-57. Date of Electronic Publication: 2023 May 25.
DOI: 10.1016/j.seizure.2023.05.018
Abstrakt: Lennox-Gastaut syndrome (LGS) is a severe, chronic, complex form of early childhood-onset epilepsy characterized by multiple seizure types, generalized slow (≤2.5 Hz) spike-and-wave activity and other electroencephalography abnormalities, and cognitive impairment. A key treatment goal is early seizure control, and several anti-seizure medications (ASMs) are available. Due to the low success rate in achieving seizure control with monotherapy and an absence of efficacy data supporting any particular combination of ASMs for treating LGS, a rational approach to selection of appropriate polytherapy should be applied to maximize benefit to patients. Such "rational polytherapy" involves consideration of factors including safety (including boxed warnings), potential drug-drug interactions, and complementary mechanisms of action. Based on the authors' clinical experience, rufinamide offers a well-considered first adjunctive therapy for LGS, particularly in combination with clobazam and other newer agents for LGS, and may be particularly useful for reducing the frequency of tonic-atonic seizures associated with LGS.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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