Vigabatrin for tuberous sclerosis complex

被引:47
作者
Curatolo, P [1 ]
Verdecchia, M [1 ]
Bombardieri, R [1 ]
机构
[1] Univ Roma Tor Vergata, Dept Neurosci, I-00133 Rome, Italy
关键词
vigabatrin; tuberous sclerosis; infantile spasms; partial seizures;
D O I
10.1016/S0387-7604(01)00290-X
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Vigabatrin (VGB) was found to be an effective anti-epileptic drug to reduce infantile spasms in about 50% of patients and it has been found most effective in infantile spasms due to tuberous sclerosis (TSC) in which up to 95% of infants had complete cessation of their spasms. VGB was synthesized to enhance inhibitory gamma-aminobutyric acidergic (GABAergic) transmission by elevating GABA levels via irreversible inhibition of GABA transaminase. The mechanism underlying the particular efficacy of VGB in TSC is still unknown. However, its efficacy suggests that epileptogenesis in TSC may be related to an impairment of GABAerggic transmission. VGB should be considered as the first line monotheraphy for the treatment of infantile spasms in infants with confirmed diagnosis of TSC. The efficacy of VGB treatment can be assessed in less than 10 days, but usually a few days treatment with a dose of about 100 mg/kg/day stops infantile spasms. The cessation of the spasms is associated with a marked improvement of behaviour and mental development. Unfortunately, it has become clear that the use of VGB is associated with a late appearance of visual-field defects in up to 50% of patients. Currently the minimum duration and doses of VGB treatment that can produce side effects are unknown. The feasibility of using short treatment periods (2-3 months) should be investigated. (C) 2001 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:649 / 653
页数:5
相关论文
共 32 条
[1]   Vigabatrin as initial therapy for infantile spasms: A European retrospective survey [J].
Aicardi, J ;
Hauser, E ;
Steinbock, H ;
Szyper, M ;
Holsteen, V ;
Ostergaard, J ;
Pedersen, SA ;
Taudorf, K ;
BarthezCarpentier, MA ;
BadinandHubert, N ;
Berquin, P ;
Boulloche, J ;
Bourgeois, M ;
Carriere, JP ;
Chabrol, B ;
Chiron, C ;
Claris, O ;
Echenne, B ;
GauthierMorel, D ;
Livet, MO ;
Lopez, N ;
Mancini, J ;
Netter, JC ;
Quillerou, D ;
Richelme, CH ;
Rousselle, C ;
DeStMartin, A ;
DeSwarte, M ;
Auerswald, G ;
Brandl, U ;
Kurlemann, G ;
Siemes, H ;
Spohr, HL ;
Aarts, WFM ;
Begeer, JH ;
Heersma, DJ ;
Laan, LAEM ;
Peters, ACB ;
Cavazzutti, GB ;
Curatolo, P ;
Fois, A ;
Franzoni, E ;
Gobbi, G ;
Incorpora, G ;
Vigevano, F ;
Campistol, J ;
Campos, J ;
Casas, C ;
Herranz, JL ;
Nieto, M .
EPILEPSIA, 1996, 37 (07) :638-642
[2]  
Appleton R E, 1995, Seizure, V4, P45, DOI 10.1016/S1059-1311(05)80077-9
[3]  
Arndt CF, 1999, EPILEPSIA, V40, P256
[4]  
CHIRON C, 1991, J CHILD NEUROL, V6, pS52
[5]   Randomized trial comparing vigabatrin and hydrocortisone in infantile spasms due to tuberous sclerosis [J].
Chiron, C ;
Dumas, C ;
Jambaque, I ;
Mumford, J ;
Dulac, O .
EPILEPSY RESEARCH, 1997, 26 (02) :389-395
[6]   VIGABATRIN IN INFANTILE SPASMS [J].
CHIRON, C ;
DULAC, O ;
LUNA, D ;
PALACIOS, L ;
MONDRAGON, S ;
BEAUMONT, D ;
MUMFORD, JP .
LANCET, 1990, 335 (8685) :363-364
[7]   Physiological modulation of GABAA receptor plasticity by progesterone metabolites [J].
Concas, A ;
Follesa, P ;
Barbaccia, ML ;
Purdy, RH ;
Biggio, G .
EUROPEAN JOURNAL OF PHARMACOLOGY, 1999, 375 (1-3) :225-235
[8]   New developments in the neurobiology of the tuberous sclerosis complex [J].
Crino, PB ;
Henske, EP .
NEUROLOGY, 1999, 53 (07) :1384-1390
[9]   VIGABATRIN FOR REFRACTORY PARTIAL SEIZURES IN CHILDREN WITH TUBEROUS SCLEROSIS [J].
CURATOLO, P .
NEUROPEDIATRICS, 1994, 25 (01) :55-55
[10]  
CURATOLO P, 1988, NEUROPHYSIOL CLIN, V18, P149