An 8-year-old boy developed tremor, unsteadiness, chorea, and eye movement abnormalities on starting lamotrigine for myoclonic jerks. Investigations for a neurodegenerative disorder were negative. Symptoms and signs resolved on stopping lamotrigine. He was well and asymptomatic on follow-up after 4 years. Another 7-year-old boy who started on lamotrigine for suspected absence seizures developed abnormalities of eye movement with associated cognitive decline, which also resolved on discontinuing the medication. Eye movement abnormalities, involuntary movements, and behavioral changes appear to be unusual side effects of lamotrigine therapy. (J Child Neurol 2003;18:479—480).
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References
1.
Besag FM, Wallace SJ, Dulac O., et al:Lamotrigine for the treatment of epilepsy in childhood. J Pediatr1995;127:991—997.
2.
British National Formulary.London, British Medical Association & Royal Pharmaceutical Society of Great Britain, 2002;43: 226—232.
Affonseca Sotero de Menezes M., Rho JM, Murphy P., et al: Lamotrigine-induced tic disorder: Report of five pediatric cases. Epilepsia2000;41:862—867.
5.
Cassidy L., Taylor D., Harris CM: Abnormal supranuclear eye movements in the child—A practical guide to examination and interpretation. Surv Ophthalmol2000;44:479—506.
6.
Garbutt S., Harris CM: Abnormal vertical optokinetic nystagmus in infants and children. Br J Ophthalmol2000;84:451—455.
7.
Peck AW: Clinical pharmacology of lamotrigine. Epilepsia1991;32(Suppl): S9—S12.
8.
Hamilton MJ, Cohen AF, Yeun AW, et al: Carbamazepine and lamotrigine in healthy volunteers: Relevance to early tolerance and clinical trial dosage. Epilepsia1993;34:166—173.
9.
Cohen AF, Ashby L., Crowley D., et al: Lamotrigine (BW430C), a potential anticonvulsant. Effects on the central nervous system in comparison with phenytoin and diazepam. Br J Clin Pharmacol1985;20:619—629.
10.
Verma A., Miller P., Carwile ST, et al: Lamotrigine induced blepharospasm. Pharmacotherapy1999;19:877—880.
11.
Buchanan N. : Lamotrigine: Clinical experience in 200 patients with epilepsy with follow-up up to four years. Seizure1996; 5:209—214.
12.
Catania S., Cross H., de Sousa C., et al: Paradoxic reaction to lamotrigine in a child with benign focal epilepsy of childhood with centrotemporal spikes. Epilepsia1999;40:1657—1660.
13.
Guerrini R. , Dravet C., Genton P., et al: Lamotrigine and seizure aggravation in severe myoclonic epilepsy. Epilepsia1998 ;39:508—512.
14.
Zipp F., Bass H., Fischer PA: Lamotrigine-antiparkinsonian activity by blockade of glutamate release? J Neural Transm1993; 5:67—75.
15.
Neville Bgr: Steroid responsive motor disorders associated with epilepsy, in Guerrini R, Aicardi J, Andermann F, Hallett M (eds): Epilepsy and Movement Disorders. Cambridge , Cambridge University Press, 2001 , 511—516.
