banzel connections

What to Expect From Treatment
By Steven Wolf, MD and Patty McGoldrick, NP

Your child may have recently been diagnosed with Lennox-Gastaut syndrome (LGS).

Your doctor came to this conclusion based on the following features1:

  • Experience several seizure types, sometimes many times a day
  • Developmental delay or cognitive impairment
  • A certain brainwave pattern seen on an electroencephalogram (EEG)

It’s likely that you’ve been searching for an answer for a while. These characteristics often do not appear all at once.1

Now that you know that your child has LGS2, you and your healthcare provider can start taking steps to help manage your child’s condition.

The first thing you should probably know is that there is no cure for LGS.2 However, the goal of treatment should be that your child experience the fewest number of seizures as possible with the fewest number of medications with the fewest side effects.

Medication and other treatment options

There are a variety of treatments that your doctor may prescribe, depending on how severe your child’s LGS is. These may include:

Anti-epileptic drugs (AEDs) for LGS, like BANZEL.

These work to help the neurons in the brain become less excitable.³

Anti-epileptic drugs (AEDs) for LGS, like BANZEL.

Diet, like the ketogenic diet.

The ketogenic diet is a special high-fat, low-carbohydrate, low-protein diet. It has been found to reduce seizures in some people with epilepsy.⁴ The diet makes the body burn fat instead of glucose for energy.⁴ The ketogenic diet requires that you partner with your healthcare team to accurately implement it. Be sure to talk with your healthcare team before starting this diet, as side effects can be serious. Dehydration, renal stones, cardiac abnormalities, and abnormal lipid profile may occur.⁵

Diet, like the ketogenic diet.

Surgery.

There are different types of epilepsy surgery that may help decrease seizures in people with LGS.⁶ One common surgery is called corpus callosotomy.⁶ A neurosurgeon will cut the fiber that connects the left side and right side of the brain. This won’t stop seizures, but may limit the spread of electrical activity from one side of the brain to the other.⁷ Additional surgical options include resections (during which the abnormal area of the brain that is causing the seizures is removed), multiple subpial transections (in which the area of the brain causing the seizures is interrupted),⁸ and vagus nerve stimulators (an implantation like a pacemaker to decrease the frequency of seizures).⁹

Surgery.

Continue partnering with your child’s healthcare team to find the treatments that reduce the number and severity of seizures your child experiences.

Side Effects

Every medication has the potential to cause side effects. Ask your healthcare team which side effects are most common and what you can do to help manage them. Possible allergic reactions and any potential side effects should be reported to your healthcare team and dealt with immediately. These include rashes and difficulty breathing or swallowing. Call your doctor immediately if an allergic reaction is suspected.

Drug interactions

Certain medications can interact with other seizure medications and either lower or raise the amount of medicine in the blood.10 Talk to your healthcare provider about all potential drug interactions between the medications your loved one may be taking.

It’s important to work with your healthcare team to find the right treatment that works for your loved one. Finding the right combination of treatments may take a while, and it may be frustrating. But finding the right combination of treatments and balancing their benefits against possible side effects is simply part of the process.

Dr Wolf and Ms McGoldrick run a collaborative partnership in the care of people with epilepsy at a comprehensive epilepsy center in New York.

Dr Wolf and Ms McGoldrick are paid consultants of Eisai Inc.

What To Expect From Treatment
Seizures Associated With LGS
Partnering With Your Healthcare Team
Possible Seizure Triggers
Creating a Safe Home Environment
Outside-the-Home Activities
How Epilepsy Centers Can Help
References:
  1. Arzimanoglou A, French J, Blume WT, et al. Lennox-Gastaut syndrome: a consensus approach on diagnosis, assessment, management, and trial methodology. Lancet Neurol. 2009;8(1):82-93.
  2. Treatments for Lennox-Gastaut syndrome. http://www.lgsfoundation.org/treatments. Accessed April 26, 2014.
  3. LGS Foundation Web site. How medicines work. Epilepsy Foundation Web site. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-medicines/how-medicines-work. Accessed July 19, 2017.
  4. Hartman AL, Gasior M, Vining EPG, Rogawski MA. The neuropharmacology of the ketogenic diet. Pediatr Neurol. 2007;36(5):281-292.
  5. Cherian KA, Glauser TA, Morita DA, Stannard KM. Lennox-Gastaut syndrome treatment & management. eMedicine Web site. http://emedicine.medscape.com/article/1176735-treatment. Updated July 27, 2016. Accessed July 19, 2017.
  6. Epilepsy Foundation. LGS: surgery. http://www.epilepsy.com/information/lennox-gastaut-syndrome/treatment-overview/lgs-surgery. Accessed July 19, 2017.
  7. Weiner HL. Sirven JI. Corpus callosotomy. Epilepsy Foundation Web site. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/surgery/types-surgeries/corpus-callosotomy. Accessed July 19, 2017.
  8. Weiner HL. Sirven JI. Types of surgeries. Epilepsy Foundation Web site. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/surgery/types-surgeries. Accessed July 19, 2017.
  9. Schachter SC, Sirven JI. Vagus nerve stimulation (VNS). Epilepsy Foundation Web site. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/vagus-nerve-stimulation-vns. Accessed July 19, 2017.
  10. Schachter SC, Shafer PO, Sirven JI. Illness and over-the-counter (OTC) medicines. Epilepsy Foundation Web site. http://www.epilepsy.com/learn/triggers-seizures/illness-and-over-counter-otc-medicines. Accessed July 19, 2017.