Seizure control in mono- and combination therapy in a cohort of patients with Idiopathic Generalized Epilepsy

Idiopathic Generalized Epilepsy (IGE) patients may not achieve optimal seizure control with monotherapy. Our goal was to evaluate the efficacy of combination therapy in a retrospective series of IGE patients receiving different antiseizure medication (ASM) regimens. We retrospectively identified all...

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Bibliographic Details
Published in:Scientific reports 2022-07, Vol.12 (1), p.12350-12350, Article 12350
Main Authors: Pipek, Leonardo Zumerkorn, Pipek, Henrique Zumerkorn, Castro, Luiz Henrique Martins
Format: Article
Language:English
Subjects:
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Combination therapy
Convulsions & seizures
EEG
Epilepsy
Fetuses
Humanities and Social Sciences
Immunoglobulin E
Intrauterine exposure
multidisciplinary
Patients
Science
Science (multidisciplinary)
Seizures
Valproic acid
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Summary:Idiopathic Generalized Epilepsy (IGE) patients may not achieve optimal seizure control with monotherapy. Our goal was to evaluate the efficacy of combination therapy in a retrospective series of IGE patients receiving different antiseizure medication (ASM) regimens. We retrospectively identified all patients with adolescence onset IGE with typical clinical and EEG features from a single epilepsy specialist clinic from 2009 to 2020. We evaluated long-term seizure control, for VPA, LEV, LTG mono and combination therapy. We studied 59 patients. VPA was more commonly used in men (84%) than in women (44%) ( p   0.05). Combination therapy was superior to LEV and LTG monotherapy for complete control ( p  = 0.03), without differences for minor seizures and pseudoresistance outcomes ( p  > 0.05). Combination therapy not including VPA was also non-inferior to VPA monotherapy in all settings. Combination therapy was superior to LTG and LEV monotherapy in IGE, and may be equally effective including or not VPA. Combination therapy including LTG, LEV, and/or VPA is an effective treatment option after monotherapy failure with one of these ASM in IGE. Dual therapy with LEV–LTG should be considered in monotheraphy failure, to avoid fetal effects of in utero VPA exposure.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-16718-x