Neurogenetic disorders and treatment of associated seizures

Pharmacotherapy. 2013 Mar;33(3):330-43. doi: 10.1002/phar.1201. Epub 2013 Feb 11.

Abstract

Seizures are a frequent complication associated with several neurogenetic disorders. Antiepileptic medications remain the mainstay of treatment in these patients. We summarized the available data associated with various antiepileptic therapies used to treat patients with neurogenetic disorders who experienced recurrent seizures. A MEDLINE search was conducted to identify articles and abstracts describing the use of antiepileptic therapy for the treatment of various neurogenetic syndromes. Of all the neurogenetic syndromes, only autism spectrum disorders, Angelman syndrome, Rett syndrome, Dravet syndrome, and tuberous sclerosis complex were identified as having sufficient published information to evaluate therapy. Some efficacy trends were identified, including frequent successes with valproic acid with clonazepam for epilepsy with Angelman syndrome; valproic acid, stiripentol, and clobazam (triple combination therapy) for epilepsy with Dravet syndrome; and vigabatrin for infantile spasms associated with tuberous sclerosis complex. Due to a paucity of information regarding the mechanisms by which seizures are generated in the various disorders, approach to seizure control is primarily based on clinical experience and a limited amount of study data exploring patient outcomes. Although exposure of the developing brain to antiepileptic medications is of some concern, the control of epileptic activity is an important undertaking in these individuals, as the severity of eventual developmental delay often appears to correlate with the severity of seizures. As such, early aggressive therapy is warranted.

Publication types

  • Review

MeSH terms

  • Angelman Syndrome / complications
  • Angelman Syndrome / drug therapy*
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Epilepsies, Myoclonic / complications
  • Epilepsies, Myoclonic / drug therapy*
  • Humans
  • Rett Syndrome / complications
  • Rett Syndrome / drug therapy*
  • Seizures / complications
  • Seizures / drug therapy*
  • Treatment Outcome
  • Tuberous Sclerosis / complications
  • Tuberous Sclerosis / drug therapy*

Substances

  • Anticonvulsants