Abstract

LennoxGastaut Syndrome: A Prospective Follow-up Study.

Rathaur, Bhanu Pratap Garg, Ravindra Kumar Malhotra, Hardeep Singh Kumar, Neeraj Sharma, Praveen Kumar Verma, Rajesh Uniyal, Ravi

Abstract


Objectives:: LennoxGastaut syndrome is a catastrophic epileptic encephalopathy. In LennoxGastaut syndrome, seizures are resistant to pharmacological treatment. In this prospective study, we evaluated the clinical features, neuroimaging, and response to treatment. Materials and Methods:: Forty-three consecutive newly diagnosed patients of LennoxGastaut syndrome were enrolled in the study. Baseline clinical assessment included seizure semiology, seizure frequency, electroencephalography, and neuroimaging. Patients were treated with combinations of preferred antiepileptic drugs (sodium valproate [VPA], clobazam [CLB], levetiracetam [LVT], lamotrigine [LMT], and topiramate [TPM]). Patients were followed for 6 months. The outcome was assessed using modified Barthel index. Results:: Tonic and generalized tonic-clonic forms were the most common seizures types. Features suggestive of hypoxic-ischemic encephalopathy (37.2%) were most frequent neuroimaging abnormality. Neuroimaging was normal in 32.6% of patients. With a combination valproic acid (VPA), CLB, and LVT, in 81.4% of patients, we were able to achieve >50% reduction in seizure frequency. Eleven (25.58%) patients showed an improvement in the baseline disability status. Conclusions:: A combination of VPA, CLB, and LVT is an appropriate treatment regimen for patients with LennoxGastaut syndrome.


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