Stimulant Use in Patients With Sturge-Weber Syndrome: Safety and Efficacy

• Published in: Pediatric neurology 2014-11, Vol.51 (5), p.675-680
• Main Authors: Lance, Eboni I., MD, Lanier, Kira E., BA, Zabel, T. Andrew, PhD, Comi, Anne M., MD
• Format: Article
• Language: English
• Subjects: ADHD; Adolescent; Brain - drug effects; Brain - pathology; Central Nervous System Stimulants - pharmacology; Central Nervous System Stimulants - therapeutic use; Child; Child, Preschool; Databases, Factual - statistics & numerical data; Drug-Related Side Effects and Adverse Reactions - etiology; Female; Humans; Male; neurocutaneous syndromes; Neurology; Pediatrics; Retrospective Studies; Statistics, Nonparametric; stimulant medication; Sturge Weber syndrome; Sturge-Weber Syndrome - drug therapy; Sturge-Weber Syndrome - pathology; Young Adult
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2013.11.009

Abstract Background Sturge-Weber syndrome is characterized by a facial port-wine birthmark, vascular eye abnormalities, and a leptomeningeal angioma. Attention and behavioral issues are common in Sturge-Weber syndrome. However, literature evidence for stimulant treatment is minimal. This study evaluates stimulant medication safety and efficacy in individuals with Sturge-Weber syndrome. Methods The research database of the Hunter Nelson Sturge-Weber Center (n = 210 subjects in the database) was reviewed for stimulant use. Twelve patients (mean age 10.5 years, age range 4 to 21 years) on stimulants were seen between 2003 and 2012. A retrospective chart review obtained comorbid diagnoses, stimulant type and dosage, medication side effects, vital signs, and medication efficacy. Results All 12 patients had brain involvement (unilateral, nine; bilateral, three). Additional comorbidities included epilepsy (twelve), hemiparesis (eight), headaches (eight), and vision deficits (six). Eight patients reported side effects, primarily appetite suppression (four) and headaches (three). There were no statistically significant changes in weight or blood pressure 6 months after medication initiation. Medication efficacy was subjectively reported in 11 patients. Seven patients remained on stimulants at their most recent follow-up visit. Conclusions This study preliminarily evaluates stimulant medication use in a small group of Sturge-Weber syndrome patients. Stimulants were tolerated and effective in most subjects. Side effects were mostly minor and medication did not negatively affect growth or vital signs. Stimulant medication may be a safe and effective intervention for Sturge-Weber syndrome children with attention issues/attention deficit hyperactivity disorder. Further studies with larger sample sizes are needed.