Effectiveness of antiepileptic therapy in patients with PCDH19 mutations

Jan Lotte, Thomas Bast, Peter Borusiak, Antonietta Coppola, J. Helen Cross, Petia Dimova, Andras Fogarasi, Irene Graneß, Renzo Guerrini, Helle Hjalgrim, Reinhard Keimer, Christian M. Korff, Gerhard Kurlemann, Steffen Leiz, Michaela Linder-Lucht, Tobias Loddenkemper, Christine Makowski, Christian Mühe, Joost Nicolai, Marina NikanorovaSimona Pellacani, Sunny G. Philip, Susanne Ruf, Iván Sánchez Fernández, Kurt Schlachter, Pasquale Striano, Biayna G. Sukhudyan, Deyana Valcheva, R. Jeroen Vermeulen, Tanja Weisbrod, Bernd Wilken, Philipp Wolf, Gerhard Kluger

Research output: Contribution to journalArticle

Abstract

PURPOSE: PCDH19 mutations cause epilepsy and mental retardation limited to females (EFMR) or Dravet-like syndromes. Especially in the first years of life, epilepsy is known to be highly pharmacoresistant. The aim of our study was to evaluate the effectiveness of antiepileptic therapy in patients with PCDH19 mutations.

METHODS: We report a retrospective multicenter study of antiepileptic therapy in 58 female patients with PCDH19 mutations and epilepsy aged 2-27 years (mean age 10.6 years).

RESULTS: The most effective drugs after 3 months were clobazam and bromide, with a responder rate of 68% and 67%, respectively, where response was defined as seizure reduction of at least 50%. Defining long-term response as the proportion of responders after 12 months of treatment with a given drug in relation to the number of patients treated for at least 3 months, the most effective drugs after 12 months were again bromide and clobazam, with a long-term response of 50% and 43%, respectively. Seventy-four percent of the patients became seizure-free for at least 3 months, 47% for at least one year.

SIGNIFICANCE: The most effective drugs in patients with PCDH19 mutations were bromide and clobazam. Although epilepsy in PCDH19 mutations is often pharmacoresistant, three quarters of the patients became seizure-free for at least for 3 months and half of them for at least one year. However, assessing the effectiveness of the drugs is difficult because a possible age-dependent spontaneous seizure remission must be considered.

Original languageEnglish
Pages (from-to)106-10
Number of pages5
JournalSeizure
Volume35
DOIs
Publication statusPublished - Feb 2016

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Anticonvulsants
  • Cadherins
  • Child
  • Child, Preschool
  • Epilepsy
  • Female
  • Follow-Up Studies
  • Humans
  • Mutation
  • Pharmacogenetics
  • Red Cross
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult
  • Journal Article
  • Multicenter Study

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  • Cite this

    Lotte, J., Bast, T., Borusiak, P., Coppola, A., Cross, J. H., Dimova, P., Fogarasi, A., Graneß, I., Guerrini, R., Hjalgrim, H., Keimer, R., Korff, C. M., Kurlemann, G., Leiz, S., Linder-Lucht, M., Loddenkemper, T., Makowski, C., Mühe, C., Nicolai, J., ... Kluger, G. (2016). Effectiveness of antiepileptic therapy in patients with PCDH19 mutations. Seizure, 35, 106-10. https://doi.org/10.1016/j.seizure.2016.01.006