It is well known that Doose and Lennox-Gastaut syndromes are drug resistant epileptic encephalopathies. There do exist typical AED for them. Nevertheless, although AED as
carbamazepine is not recommended -as a result of the many possible side effects it may cause- does there exist any report about any child/adult which was in good control of seizures with levetiracetam, etosuximide, topiramate, lamotrigone and clobazam and - in order to "increase seizure control" those AED are retired slowly, levetiracetam is changed by brivaracetam BUT CARBAMAZEPINE is introduced as "the new one" and is suppported by risperidone...?
I will acknowledge any comment.
Dear Ricardo
To the best of my knowledge, there are no data about a possible increase of early death rate in LGS patients treated with CBZ.
Anyway, LGS has an increased risk of early death, especially in patients with high seizure rate (DOI: 10.1177/0883073809348355). CBZ can exacerbate seizures in LGS, especially tonic seizures (frequent during sleep).
I can argue that this might increase the risk factors for early death in selected LGS patients.
Bw
Elena Gardella
Dear Elena,
Thank you very much for your kind answer. I'll read the paper you kindly cite. According to your experience, what could be the worst damage? I mean, there is a patient with posible Dosse/LG syndrome. But the patient consumes levetiracetam, ethousuximide, topiramate, lamotrigine and clobazam and since a long time ago neurologists warned to avoid CBZ. Even immunoglobuline was used successfully several times until stopping. But I'm very curious about knowing the worst reaction of CBZ in an scenario like this one. I'd appreciate a lot to have your opinión again. Best wishes!!!
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