Vigabatrin

James Wheless, R. Eugene Ramsay, Stephen D. Collins

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Refractory epilepsies such as infantile spasms (IS) and complex partial seizures (CPS) can have a severe negative impact on the neurological integrity and quality of life of affected patients, in addition to drastically increasing their risk of premature mortality. Early identification of potentially effective pharmacotherapy agents is important. Vigabatrin has been shown to be a generally well tolerated and effective antiepileptic drug (AED) in a wide variety of seizure types affecting both children and adults, particularly those with IS and CPS. A bilateral, concentric constriction of the peripheral visual field characterizes the visual field defect (VFD) associated with vigabatrin, well characterized by numerous studies. This peripheral VFD presents in 30-50% of patients with exposure of several years; however, most of these patients are asymptomatic. In well-controlled studies, the earliest onset in patients with CPS is 11 months and at 5 months in infants, with average onsets being more than 5 years and 1 year, respectively. Patients with a peripheral VFD retain an average 65° of lateral vision (normal, 90°). The fact that many patients never develop the vigabatrin-related peripheral VFD, despite long-term exposure at high doses, may support the hypothesis that the injury is an idiosyncratic adverse drug reaction (as opposed to a strict dose- or duration-dependent toxicity). Effective testing methods are available to aid in the early detection and management of the peripheral VFD. This article discusses issues of importance to clinical decision-making in the use of vigabatrin to assist the physician and patient in assessing the benefits of vigabatrin therapy and understanding the potential risks of the VFD and uncontrolled seizures.

Original languageEnglish (US)
Pages (from-to)163-172
Number of pages10
JournalNeurotherapeutics
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2007

Fingerprint

Vigabatrin
Visual Fields
Seizures
Infantile Spasms
Premature Mortality
Drug-Related Side Effects and Adverse Reactions
Constriction
Anticonvulsants
Epilepsy
Quality of Life
Physicians
Drug Therapy
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Wheless, J., Ramsay, R. E., & Collins, S. D. (2007). Vigabatrin. Neurotherapeutics, 4(1), 163-172. https://doi.org/10.1016/j.nurt.2006.11.008

Vigabatrin. / Wheless, James; Ramsay, R. Eugene; Collins, Stephen D.

In: Neurotherapeutics, Vol. 4, No. 1, 01.01.2007, p. 163-172.

Research output: Contribution to journalArticle

Wheless, J, Ramsay, RE & Collins, SD 2007, 'Vigabatrin', Neurotherapeutics, vol. 4, no. 1, pp. 163-172. https://doi.org/10.1016/j.nurt.2006.11.008
Wheless J, Ramsay RE, Collins SD. Vigabatrin. Neurotherapeutics. 2007 Jan 1;4(1):163-172. https://doi.org/10.1016/j.nurt.2006.11.008
Wheless, James ; Ramsay, R. Eugene ; Collins, Stephen D. / Vigabatrin. In: Neurotherapeutics. 2007 ; Vol. 4, No. 1. pp. 163-172.
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