Preventive vigabatrin has long-term epilepsy benefits in kids with sclerosis

Preventive treatment with antiepileptic agents in infants with tuberous sclerosis complex helps improve epilepsy control in the long-term, a recent study has found.

Researchers conducted a prospective, nonrandomized clinical trial on 14 infants with tuberculosis sclerosis complex. Preventive vigabatrin medication was initiated upon the detection of epileptic discharges on serial electroencephalography. Long-term outcomes were compared against a parallel group of 31 infants who received medication only after the onset of clinical seizures.

In the arm that received preventive medication, the median intelligence quotient (IQ) was 94, while 21 percent (n=14) of the participants had moderate or severe intellectual disabilities. Two children in this group had no consent for IQ assessment but nevertheless showed no evidence of epileptogenesis or seizures. They also appeared to have normal cognitive development and were able to attend regular primary school without special needs.

In the comparator group, the median IQ was 46, and 72 percent were diagnosed with intellectual disability. Six (24 percent) had severe and three (12 percent) had profound disability.

Comparison between groups revealed a significant benefit in favour of preventive treatment, both in terms of neuropsychologic measures (p<0.03) and the prevalence of intellectual disability (p=0.003).

The same was true for epilepsy outcomes. At the final follow-up visit, almost all of those who received standard medication developed clinical seizures, as opposed to only half in the preventive-treatment group (96 percent vs 50 percent; p=0.001).