Valproate and lamotrigine combination therapy in children with drug-resistant focal epilepsy: an observational analysis focusing on neuroimaging abnormalities

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2025-07-11 DOI:10.1016/j.braindev.2025.104395

Shiena Watanabe , Takashi Enokizono , Mitsuyo Nishimura , Kazushi Maruo , Tomoya Iwasaki , Yui Tsunoda , Yuichi Ueno , Mai Tanaka , Yui Takada , Ryuta Tanaka , Kota Araki , Yosuke Masuda , Eiichi Ishikawa , Hidetoshi Takada

{"title":"Valproate and lamotrigine combination therapy in children with drug-resistant focal epilepsy: an observational analysis focusing on neuroimaging abnormalities","authors":"Shiena Watanabe , Takashi Enokizono , Mitsuyo Nishimura , Kazushi Maruo , Tomoya Iwasaki , Yui Tsunoda , Yuichi Ueno , Mai Tanaka , Yui Takada , Ryuta Tanaka , Kota Araki , Yosuke Masuda , Eiichi Ishikawa , Hidetoshi Takada","doi":"10.1016/j.braindev.2025.104395","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the efficacy of valproate and lamotrigine (VPA–LTG) combination therapy in pediatric patients with drug-resistant focal epilepsy (DRFE), focusing on the presence of neuroimaging abnormalities.</div></div><div><h3>Methods</h3><div>Pediatric patients with epilepsy who visited the University of Tsukuba Hospital and Ibaraki Children's Hospital between October 2021 and September 2024 were included in this retrospective chart review. Patients with DRFE who received VPA–LTG combination therapy were enrolled.</div></div><div><h3>Results</h3><div>Data from 21 patients, including 16 males and 5 females, in the age range of 1.8–13.9 years were examined. The median numbers of previously failed anti-seizure medications (ASMs) and concurrent ASMs were 4 (range: 2–7) and 3 (range: 2–5), respectively. The overall responder rate (defined as the percentage of patients achieving ≥50 % seizure reduction over the last 12 months) was 38 %. The responder rate in patients without MRI abnormalities (67 %) was significantly higher than that in patients with MRI abnormalities (16 %). Patients with MRI abnormalities had more structural etiologies (42 %), whereas those without MRI abnormalities had more unknown etiologies (89 %).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that VPA–LTG combination therapy is a promising option for pediatric patients with DRFE without neuroimaging abnormalities.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104395"},"PeriodicalIF":1.3000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain & Development","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0387760425000774","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This study aimed to investigate the efficacy of valproate and lamotrigine (VPA–LTG) combination therapy in pediatric patients with drug-resistant focal epilepsy (DRFE), focusing on the presence of neuroimaging abnormalities.

Methods

Pediatric patients with epilepsy who visited the University of Tsukuba Hospital and Ibaraki Children's Hospital between October 2021 and September 2024 were included in this retrospective chart review. Patients with DRFE who received VPA–LTG combination therapy were enrolled.

Results

Data from 21 patients, including 16 males and 5 females, in the age range of 1.8–13.9 years were examined. The median numbers of previously failed anti-seizure medications (ASMs) and concurrent ASMs were 4 (range: 2–7) and 3 (range: 2–5), respectively. The overall responder rate (defined as the percentage of patients achieving ≥50 % seizure reduction over the last 12 months) was 38 %. The responder rate in patients without MRI abnormalities (67 %) was significantly higher than that in patients with MRI abnormalities (16 %). Patients with MRI abnormalities had more structural etiologies (42 %), whereas those without MRI abnormalities had more unknown etiologies (89 %).

Conclusion

Our findings suggest that VPA–LTG combination therapy is a promising option for pediatric patients with DRFE without neuroimaging abnormalities.

查看原文本刊更多论文

丙戊酸和拉莫三嗪联合治疗儿童耐药局灶性癫痫：一项针对神经影像学异常的观察性分析

目的探讨丙戊酸钠和拉莫三嗪（VPA-LTG）联合治疗小儿耐药局灶性癫痫（DRFE）的疗效，重点关注存在神经影像学异常的患儿。方法回顾性分析2021年10月至2024年9月在筑波大学医院和茨城市儿童医院就诊的癫痫患儿。本研究纳入了接受VPA-LTG联合治疗的DRFE患者。结果21例患者，男16例，女5例，年龄1.8 ~ 13.9岁。先前失败的抗癫痫药物（asm）和并发的asm的中位数分别为4（范围：2-7）和3（范围：2-5）。总体应答率（定义为在过去12个月内癫痫发作减少≥50%的患者百分比）为38%。无MRI异常患者的应答率（67%）明显高于MRI异常患者（16%）。MRI异常的患者有更多的结构性病因（42%），而没有MRI异常的患者有更多的未知病因（89%）。结论VPA-LTG联合治疗对于无神经影像学异常的DRFE患儿是一个很有希望的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.