Sumary of Preventive treatment positively alters ‘natural history of severe infantile epilepsy’:
- Preventive treatment with vigabatrin effectively altered the natural history of seizures among infants with tuberous sclerosis complex, decreasing the risk for and severity of epilepsy, according to results published in Annals of Neurology..
- “Current guidelines recommend antiepileptic treatment after two unprovoked clinical seizures or after one seizure in patients at high risk (>.
- Most individuals with TSC exhibit asymptomatic epileptiform activity on electroencephalography (EEG) prior to the onset of clinical seizures, according to the researchers, followed by asymptomatic electrographic seizures..
- Previous research, though small, demonstrated that starting antiepileptic treatment in infants with TSC after epileptiform activity or electrographic seizures was first identified improved epilepsy-related outcomes at 2 years of age compared with a historical control group in which treatment began after clinical seizures..
- Katarzyna Kotulska, MD, PhD, of the department of neurology and epileptology at the Children Memorial Health Institute in Poland, and colleagues conducted the present study as part of the EPISTOP project, a long-term prospective study examining clinical and molecular biomarkers for epileptogenesis in a genetic model of epilepsy/TSC..
- Participants received vigabatrin 100 mg/kg/day or 150 mg/kg/day either as conventional antiepileptic treatment, after the first electrographic or clinical seizure, or preventively, when the researchers identified epileptiform EEG activity before a clinical seizure..
- Preventive treatment resulted in a significantly longer time to first clinical seizure compared with conventional treatment, according to the study findings (RCT:.
- At 24 months, the pooled analysis demonstrated that preventive treatment decreased the risk for clinical seizures (OR = 0.21;.
- In the RCT and the OLT, participants who received preventive treatment were about three times more likely to remain free from clinical seizures throughout the study period compared with participants in the conventional treatment group (RCT:.
- Participants receiving preventive treatment demonstrated a significantly lower proportion of days with seizures until 2 years of age compared with conventional treatment in the RCT (17% vs…