G Barcs1, P Halász. 1. National Institute of Psychiatry and Neurology, Budapest, Hungary.
Abstract
INTRODUCTION: The main objective of this retrospective study was the further exploration of the loss of efficiency of the clobazam therapy (CLOB tolerance) in resistant temporal lobe epilepsy (TLE). MATERIAL AND METHODS: For up to 42 months we closely followed the state of 55 TLE patients placed on CLOB as an add-on therapy. Also, we sought for a connection between CLOB tolerance and clinical characteristics. RESULTS: By the end of the 1st month 71% of the patients were seizure-free; 20% improved; 3% relapsed totally and 6% did not respond at all. After 24 months 15% were seizure-free, 11% maintained the original improved state, 36% relapsed totally and 32% partially--which remained unchanged thereafter. Long-term efficiency was in inverse proportion to the pretreatment interictal spike activity. No significant cross-tolerance was noted between CLOB and clonazepam. CONCLUSION: Although the problem of CLOB tolerance is hardly overestimated, the use of CLOB in the treatment of TLE deserves consideration--despite the possibilities new drugs offer.
INTRODUCTION: The main objective of this retrospective study was the further exploration of the loss of efficiency of the clobazam therapy (CLOB tolerance) in resistant temporal lobe epilepsy (TLE). MATERIAL AND METHODS: For up to 42 months we closely followed the state of 55 TLEpatients placed on CLOB as an add-on therapy. Also, we sought for a connection between CLOB tolerance and clinical characteristics. RESULTS: By the end of the 1st month 71% of the patients were seizure-free; 20% improved; 3% relapsed totally and 6% did not respond at all. After 24 months 15% were seizure-free, 11% maintained the original improved state, 36% relapsed totally and 32% partially--which remained unchanged thereafter. Long-term efficiency was in inverse proportion to the pretreatment interictal spike activity. No significant cross-tolerance was noted between CLOB and clonazepam. CONCLUSION: Although the problem of CLOB tolerance is hardly overestimated, the use of CLOB in the treatment of TLE deserves consideration--despite the possibilities new drugs offer.
Authors: Barry E Gidal; Robert T Wechsler; Raman Sankar; Georgia D Montouris; H Steve White; James C Cloyd; Mary Clare Kane; Guangbin Peng; David M Tworek; Vivienne Shen; Jouko Isojarvi Journal: Neurology Date: 2016-09-28 Impact factor: 9.910