HomeAnswersNeurologyseizureMy 1-year-old daughter has epilepsy in various forms. Does Vigabatrin exacerbate seizures?

Can Vigabatrin exacerbate seizures in a 1-year-old child?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At September 25, 2023
Reviewed AtDecember 27, 2023

Patient's Query

Hello doctor,

My 1-year-old daughter has been battling various forms of epilepsy since she was four months old. They began with tonic seizures, followed by tonic-myoclonic seizures. A month later, after no medicines seemed to reduce her seizure burden, she was diagnosed with infantile spasms. She failed ACTH treatment twice. However, her spasms stopped completely just one day after starting Vigabatrin. She was seizure and spasm free for about ten weeks and then had one episode a month ago. Being that we were worried it was spasms, her Vigabatrin was increased. We then saw a similar episode after a week and two weeks later. We then determined, based on the information that I gave, that what she was having was a series of focal myoclonic seizures and not spasms. This was confirmed on an EEG. Recently, we began seeing episodes almost every day. She has started the ketogenic diet, and we are seeing some improvement from that, but still having episodes. My question is this, in research I have done, speaking to a pharmacist and speaking to a nurse practitioner at our clinic. I have learned that Vigabatrin can exacerbate myoclonic seizures in a patient who previously has had them. When I asked our neurologist about this, he said only if the myoclonic seizures were generalized, not focal, which is what my daughter is having. My question is to see if this is true. Does Vigabatrin only exacerbate generalized myoclonic seizures, or could it also exacerbate focal myoclonic seizures?

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

I understand your concern.

Your query is very specific, but the reply is not so specific. It can be understood by a neurologist. Myoclonic jerks are categorized in different ways:

1. Depending on the origin as cortical, cortical-subcortical, spinal, or peripheral.

2. Based on the body distribution as focal, segmental, multifocal, or generalized.

3. Cortical and cortical sub-cortical myoclonic jerks can be generalized, multifocal, or focal.

Spinal myoclonic jerks are usually segmental or focal. Peripheral myoclonic jerks are focal only. The antiepileptics (including Vigabatrin) which have the tendency to increase myoclonic jerks usually act by increasing cortical and cortical-subcortical types of myoclonic jerks, which can manifest as either generalized or multifocal, or focal myoclonic jerks. Many times clinically, it is very difficult to find out the origin of myoclonic jerks in a patient. In my understanding, there is no differentiation that Vigabatrin can increase only generalized myoclonic jerks or only focal myoclonic jerks. Nor I could find such differentiation in literature. If you come to know such literature, please update me too, or you can meet some epileptologist personally.

Hope this answers your query.

Warm regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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