EPILEPSY AND ITS SPECIAL FORMS/EPILEPSY SYNDROMES: LENNOX-GASTAUT SYNDROME’S MEDICATIONS
Children with these multiple, difficult-to-control seizures often are given several simultaneous medications with consequent drug toxicity. The handicapping nature of the seizures, plus the drug toxicity and the continuous electrical abnormalities on the EEG, often reinforce the intrinsic brain dysfunction and produce a severely handicapped child.Valproic acid has been the most effective anticonvulsant for children with this syndrome, and it should be used alone and in high doses as the initial drug. It may, if necessary, be supplemented by one of the other anticonvulsants for generalized tonic-clonic seizures or with a benzodiazepine.We have found the ketogenic diet also quite effective and recommend its use early in the course of the syndrome. We have had less success with the MCT diet. The effectiveness of oral steroids and ACTH also has been noted. The role of a form of surgery, corpus callosum sectioning, in young children with this syndrome is under investigation.Clearly, as with infantile spasms, the Lennox-Gastaut syndrome is a most frustrating and devastating condition. This group of children make up a large proportion of the intractable seizure population. Research is badly needed to understand their condition and to develop better forms of therapy. The frustration involved in their management and the complexity of treatment lead us to suggest that these children be evaluated and managed under the consultation of sophisticated epilepsy centers with access to newer drugs.*96\208\8*
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