LAMOTRIGINE FOR THE TREATMENT OF EPILEPSY WITH CONCOMITANT COGNITIVE, EMOTIONAL-VOLITIONAL AND BEHAVIORAL DISORDERS IN GIRLS

The aim of the study is to evaluate lamotrigine efficacy on concomitant cognitive, emotional-volitional and behavioral disorders in girls with epilepsy. Materials and Methods. The study enrolled 17 girls aged 4–11 (mean age 7.4) with epilepsy, cognitive and/or emotional-volitional and behavioral deficits. The authors examined initial cognitive, emotional-volitional and behavioral impairments. To objectify the impairments, the results are expressed as percentage. The coefficient was calculated by summarizing the percentages of a particular function for each girl and then dividing the sum by the total number of subjects. After psychological and pedagogical testing, all girls underwent titrated lamotrigine monotherapy. Three-hour video-EEG monitoring (wakefulness and sleep) was carried out after 3, 6, 12, 18 and 24 months, and control Psychological and pedagogical testing – after 6, 12, 18 and 24 months. Results. Before lamotrigine therapy 7 girls (41.5 %) demonstrated focal seizures, 10 girls (58.5 %) had focal seizures with secondary bilateral synchronization. After 3 months, the number of seizures decreased in 4 girls (25.5 %), and a year later – in 14 girls (82.3 %). The group-wide indicators of perception and psychomotor pathologies were 41 %, aptitude for learning and memory – 43 %, speech – 54 %, reasoning – 41 %, social intelligence – 73 %. The indicators of emotional-volitional disorders by the hyperexcitable type were 36 %, by the inhibited type – 82 %. The indicator of ADHD was 32 %, demonstrative behavior – 91 %, negativism – 73 %, aggression – 79 %. There was a decrease in the number of seizures and the severity of concomitant complications of epilepsy in patients with lamotrigine therapy. The overall level of negativism and aggression improved, ADHD symptoms decreased in most girls, emotional-volitional control improved significantly. Significant positive changes were noted in speech, reasoning, aptitude for learning and memory. Socialization skills also improved. Conclusion. Lamotrigine is an effective antiepileptic drug. It has an antiepileptic effect, and is able to correct cognitive, emotional-volitional and behavioral disorders in patients with epilepsy.