Lamotrigine induced seizures in juvenile myoclonic epilepsy

Abstract

Juvenile myoclonic epilepsy (JME) is a common epileptic syndrome. Before the development of the new antiepileptic drugs (AEDs) after the 1990s, Valproate (VPA) was the first-line treatment in juvenile myoclonic epilepsy. However, the frequent adverse effects and the risk for teratogenicity have resulted in a search for alternative therapies especially in women. Lamotrigine (LTG), topiramate, and levetiracetam, have been used as monotherapy or adjunctive therapy for juvenile myoclonic epilepsy in small patient series. We report a case of a thirty one-years-old female suffered from severe aggravation in myoclonic and generalized tonic-clonic (GTC) seizures after decreasing the lose of VPA and initiating LTG.

Keywords

• Antiepileptic drug
• Seizure
• Juvenile myoclonic epilepsy
• Lamotrigine

References

1. Atakli, D., Sözüer, D., Atay, T., Baybas, S., Arpaci, B., 1998. Misdiagnosis and treatment in juvenile myoclonic epilepsy. Seizure 7, 63-66. Auvin, S., 2008. Treatment of juvenile myoclonic epilepsy. CNS Neurosci. Ther. 14, 227-233.
2. Bodenstein-Sachar, H., Gandelman-Marton, R., Ben-Zeev, B., Chapman, J., Blatt, I., 2011. Outcome of LTG treatment in juvenile myoclonic epilepsy. Acta Neurol. Scand. 124, 22-27.
3. Crespel, A., Genton, P., Berramdane, M., Coubes, P., Monicard, C., Baldy-Moulinier M., Gelisse, P., 2005. LTG associated with exacerbation or de novo myoclonus in idiopathic generalized epilepsies. Neurology. 65, 762-764.
4. Duncan, S., 2007. Teratogenesis of sodium VPA. Curr. Opin. Neurol. 20, 175-180.
5. Janszky, J., Rásonyi, G., Halász, P., Olajos, S., Perenyi, J., 2000. Disabling erratic myoclonus during lamotrigine therapy with high serum level-report of two cases. Clin. Neuropharmacol. 23, 86-89.
6. Mantoan, L., Walker, M., 2011. Treatment options in juvenile myoclonic epilepsy. Curr. Treat. Options Neurol. 13, 355-370.
7. Mehndiratta, M.M., Aggarwal, P., 2002. Clinical expression and EEG features of patients with juvenile myoclonic epilepsy (JME) from North India. Seizure. 11, 431-436.