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Medications for related symptoms |
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Medications for related symptoms |
Home About Lissencephaly About the LCG Forum Research Resources Children Equipment Members Contact Us SiteMap |
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Anticonvulsants : Reflux : Excessive Dribbling : Constipation : Spasticity : Ketogenic Diet
This page is provided to give you some background into which drugs are available to help with the medical problems that come with Lissencephaly. Please use this to become accustomised with what is available so that you can question your child's doctor and, if necessary, propose changes to your child's medication. For full information on any drug available in the UK see the British National Formulary website. If you believe that medications are not helping or if you think that his/her medications may need to be changed, please consult you child's doctor first.
Anticonvulsant Drugs for Seizure Treatment
There are many different types of drugs for reducing fits. The list below contains most of the common prescribable drugs available in the UK. In a survey of mainly American children with Lissencephaly, valproic acid, topiramate, lamotrigine, clonazepam, diazepam and phenobarbital were the most popular medications taken for seizures.
Abbreviations:
GTC = generalised tonic-clonic seizures
LGS = Lennox Gastaut Syndrome
IS = Infantile Spasms
| Pharmaceutical Name | UK Trade Names |
Suitable for treating |
Possible side effects |
|
ACTH corticotropin |
IS, LGS, myoclonic | behaviour changes, increased appetite, weakened immune system so they are more susceptible to infections, high blood pressure, bleeding from the stomach, risk of salt imbalance and dehydration, striking weight gain which is mostly fluid, and skin problems | |
| carbamazepine | Tegretol, Teril, Timonil | partial, GTC, mixed | nausea, vomiting, dizziness, drowsiness, headache, ataxia, visual distubances, constipation or diarrhoea, anorexia, rash more... |
| clobazam | Frisium | tonic-clonic, complex partial, myoclonic |
See diazepam |
| clonazepam | Rivotril (Klonopin - USA) |
LGS, akinetic, myoclonic, absence | drowsiness, fatigue, dizziness, muscle hypotonia, coordination disturbances; hypersalivation in infants, paradoxical aggression, irritability and mental changes; rarely, blood disorders, abnormal liver-function tests |
| diazepam | Valium (Diastat, T-Quil - USA) |
clusters, status epilepticus |
drowsiness and lightheadedness the next day; confusion; amnesia; dependence; paradoxical increase in aggression; muscle weakness; more... |
| ethosuximide | Zarontin, Emeside | absence | gastro-intestinal disturbances, weight loss, drowsiness, dizziness, ataxia, dyskinesia, hiccup, photophobia, headache, depression, and mild euphoria. Psychotic states, rashes, hepatic and renal changes, more... |
| gabapentin | (Neurontin - USA) | partial, tonic-clonic | somnolence, dizziness, ataxia, fatigue; also nystagmus, tremor, diplopia, amblyopia; pharyngitis, dysarthria, weight gain, dyspepsia, amnesia, nervousness, coughing, asthenia, paraesthesia, arthralgia, purpura, leucopenia; rhinitis, myalgia, headache, rarely pancreatitis, altered liver function tests, and Stevens-Johnson syndrome; nausea and vomiting reported |
| lamotrigine | Lamictal | partial | commonly rashes, fever, malaise, influenza-like symptoms, drowsiness and rarely hepatic dysfunction, lymphadenopathy, leucopenia, and thrombocytopenia reported in conjunction with rash; angioedema, and photosensitivity also reported; more... |
| levetiracetam | Keppra | partial | drowsiness, asthenia, dizziness; less commonly, anorexia, diarrhoea, dyspepsia, nausea, amnesia, ataxia, depression, emotional lability, aggression, insomnia, nervousness, tremor, vertigo, headache, diplopia, rash |
| lorazepam | Ativan | status epilepticus | See diazepam |
| nitrazepam | Mogadon | myoclonic, IS | drowsiness and lightheadedness the next day; confusion; amnesia may occur; dependence; see also diazepam |
| oxcarbazepine | Trileptal | partial | |
| phenobarbital
(related to phenytoin and primidone) |
neonatal, GTC, status epilepticus |
drowsiness, lethargy, mental depression, ataxia and allergic skin reactions; paradoxical excitement, restlessness and hyperkinesia in children; | |
| phenytoin
(related to phenobarbital) |
Epanutin,
(Dilantin - USA) |
GTC, complex partial | See phenobarbital |
| primidone
(related to phenobarbital) |
Mysoline | GTC, psychomot-or, focal | See phenobarbital |
| tiagabine | Gabatril | partial | diarrhoea, dizziness, tiredness, nervousness, tremor, concentration difficulties, emotional lability, speech impairment; rarely, confusion, depression, drowsiness, psychosis; leucopenia reported |
| topiramate | Topamax | partial, IS?, generalized, LGS | abdominal pain, nausea, anorexia, weight loss; impaired concentration and memory, confusion, impaired speech, emotional lability with mood disorders and depression, altered behaviour, ataxia, abnormal gait, paraesthesia, dizziness, drowsiness, fatigue, asthenia, visual disturbances, diplopia, nystagmus, acute myopia with angle-closure glaucoma, taste disorder, hypersalivation, also psychotic symptoms, aggression, cognitive problems, leucopenia |
| valproic acid (sodium valproate) | Depakote,
Valproate, Epilim, Convulex (Depakene, Depacon, Epival - USA) |
absence, GTC, partial, LGS, IS | gastric irritation, nausea, ataxia and tremor; hyperammonaemia, increased appetite and weight gain; transient hair loss (regrowth may be curly), oedema, thrombocytopenia, and inhibition of platelet aggregation; impaired hepatic function leading rarely to fatal hepatic failure. Withdraw treatment immediately if vomiting, anorexia, jaundice, drowsiness, or loss of seizure control occurs, more... |
| vigabatrin | Sabril | IS, partial, GTC | drowsiness (rarely marked sedation, stupor, and confusion with non-specific slow wave EEG), fatigue, visual field defects, dizziness, nervousness, irritability, behavioural effects such as excitation and agitation especially in children; depression, abnormal thinking, headache, nystagmus, ataxia, tremor, paraesthesia, impaired concentration; more... |
Reflux (stomach acid coming back up into the oesophagus) can cause pain and discomfort. The drugs below are a few of a large range of drugs which can reduce the effects of reflux.
| Pharmaceutical Name | UK Trade Name |
Type of medication |
| CIMETIDINE | Cimetidine, Tagamet, Dyspamet | H2 anatagonist - reduces acid output in the stomach |
| RANITIDINE | Zantac | H2 anatagonist - reduces acid output in the stomach |
| Metoclopramide | motility stimulant - helps empty the stomach |
Robinul produces good drying of salivary secretions and is low on side effects. Some children with Lissencephaly have found this to be a good way of reducing dribbling or drooling.
The first point of treatment for constipation is the use of high fibre foods (e.g. some cerials, apricots, prunes, syrup of figs) and increased fluid intake. For children where oral feeding of high fibre foods may be inappropriate, or where you have been unable to find the right foods to stimulate bowel movements, medicines may be appropriate.
Many of these medicines for constipation are available in the chemist over the counter and do not require a prescription. They include Milk of magnesia, mineral oil and Senokot. Unlike laxatives in adults, they are generally not considered to be habit forming. You should use them once or twice a day and work up on the dose until your child is having a soft BM each day. If you child starts to have diarrhoea, then you are giving too much and you should cut back on the dose.
Glycerol Suppositories are an effective solution. They operate very quickly and give almost instant relief.
Spasticity may interfere with important activities like mobility and physiotherapy. Botulinum Toxin (Botox) is a natural substance that can be injected into the muscles to decrease spasticity. It does not paralyze the muscle. Botox affects only the muscles where it is injected. The reduction in strength and spasticity is temporary. In most patients it lasts between 3 and 6 months.
Alternative Seizure Control - The Ketogenic Diet
An alternative to normal medications for treatment of seizures is the Ketogenic diet
This strictly controlled, very high-fat
diet, which is also low in carbohydrates, has been shown to reduce seizures
dramatically or eliminate them completely in a significant percentage of
children who are placed on it.
Eliminating all sugars and simple carbohydrates and severely restricting other
carbohydrates results in a condition called ketosis, in which the body burns
stored fat instead of glucose for fuel. It is not clear why ketosis inhibits
seizures, but in a study involving 150 children with difficult-to-control
epilepsy, more than half had a 50% or greater reduction in seizures and one
quarter experienced a 90% improvement.
For more information visit
Packard
Children's Hospital Stanford University Medical Centre
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