The classic triad of LGS is frequent seizures with multiple seizure types, interictal slow spike-wave and delayed mental development. The Food and Drug Administration (FDA) has approved felbamate (FBM), LTG and TPM for use in the treatment of LGS. TPM was shown to decrease drop attacks and convulsions when compared with placebo (33% of TPM patients had greater than 50% reduction in seizures, compared with 8% of placebo) . Of patients treated with LTG vs. placebo, 33% vs. 16% had greater than 50% seizure reduction . Patients treated with FBM had a 34% decrease in seizures, compared with a 16% decrease in placebo-treated patients .
Other AEDs often used in treatment of LGS, without data from controlled trials, include: VPA, vigabatrin (VGB), ZNS, PB, benzodiazepines and adrenocorticotropic hormone (ACTH) or prednisolone. Additional options include the ketogenic diet, vagus nerve stimulator or corpus callosotomy.
As with other epilepsy syndromes with multiple seizure types, targeting the most disabling seizures is important. In patients with LGS, tonic seizures cause injuries and are often the most disabling. Simple interventions, such as providing a helmet with face protection, can also be helpful.
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WHAT IT IS A three-phase plan that has been likened to the low-carbohydrate Atkins program because during the first two weeks, South Beach eliminates most carbs, including bread, pasta, potatoes, fruit and most dairy products. In PHASE 2, healthy carbs, including most fruits, whole grains and dairy products are gradually reintroduced, but processed carbs such as bagels, cookies, cornflakes, regular pasta and rice cakes remain on the list of foods to avoid or eat rarely.