The International League Against Epilepsy (ILAE) recommended gabapentin as initial monotherapy of newly diagnosed, not yet treated focal seizures in adults; for focal seizures in the elderly; and for idiopathic focal epilepsy in children (Glauser 2006; Glauser 2013). Absence seizures are brief seizures characterized by a behavioral arrest correlating with generalized 3-Hz spike and wave discharges on electroencephalogram (EEG).[1] Absence seizures occur in multiple genetic generalized epilepsies, including childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), and juvenile myoclonic epilepsy (JME).[2] Genetic generalized epilepsies comprise The NICE (2022) 17 guideline also recommends being aware that gabapentin may exacerbate seizures in people with absence seizures, tonic or atonic seizures, Dravet syndrome, or Lennox-Gastaut syndrome. Gabapentin may be considered to decrease seizure frequency in patients aged 60 years or older with new-onset focal epilepsy. Supporting evidence: One double-blind randomized study compared efficacy and tolerability of gabapentin, lamotrigine, and carbamazepine in patients aged 60 years or older. The efficacy of gabapentin (Neurontin), in generalized seizures was evaluated in this 14 week, double-blind, placebo-controlled, parallel-group, add-on, multicenter study. A total of 129 patients with refractory generalized seizures were randomized to receive either placebo or 1200 mg/day gabapentin Gabapentin is useful in treating partial seizures in children. But absence seizures, which are also common, can be made worse, so a correct diagnosis is very important. The efficacy of gabapentin (Neurontin ®) in generalized seizures was evaluated in this 14 week, double-blind, placebo-controlled, parallel-group, add-on, multicenter study. A total of 129 patients with refractory generalized seizures were randomized to receive either placebo or 1200 mg/day gabapentin as add-on therapy. Patients received their standard regimens of antiepileptic drugs (AEDs We do not know whether clonazepam or gabapentin reduces the frequency of absence seizures. What are the effects of treatments for typical absence seizures in children? Studies have demonstrated the effectiveness of gabapentin as an adjunctive treatment for various types of seizures, including partial onset seizures and generalized tonic-clonic seizures. Gabapentin compared with placebo Gabapentin may be no more effective at 2 weeks than placebo at reducing seizure rates in children with absence seizures (very low-quality evidence). Similarly, oxcarbazepine, phenytoin, phenobarbital, gabapentin, and pregabalin should not be used in the treatment of absence seizures because these medications may worsen absence seizures. Ethosuximide, valproate, and lamotrigine each have a role as treatments for childhood absence epilepsy. Care of children with childhood absence epilepsy should go beyond drug treatment and address associated behavioral and psychosocial conditions as well. Gabapentin is available in Canada by prescription only. Known as Neurontin Uses Effective against partial seizures (including secondary generalized tonic-clonic). Somewhat effective against primary generalized tonic-clonic seizures. Ineffective or worsens absence, myoclonic or tonic / atonic type seizures. How to Use Do not increase or decrease the dose without your doctor’s approval. Do not Four patients had juvenile myoclonic epilepsy, one had juvenile absence epilepsy, and one had idiopathic generalized epilepsy with photosensitivity. They found that all six patients had experienced an aggravation of seizures after oxcarbazepine was initiated. Gabapentin (Neurontin) is ineffective against absence seizures, [46] and tiagabine (Gabitril) and vigabatrin (Sabril) have been associated with the exacerbation of absence or myoclonic Certain types of antiseizure medications — such as phenytoin, carbamazepine, gabapentin, pregabalin and vigabatrin — aren’t usually used to treat absence seizures. Gabapentin monotherapy at dosages ranging from 9.7 through 19.1 mg/kg/day is well tolerated in pediatric patients aged 4 through 12 years with absence epilepsy. Hosford DA, Wang Y. Utility of the lethargic (lh/lh) mouse model of absence seizures in predicting the effects of lamotrigine, vigabatrin, tiagabine, gabapentin, and topiramate against human absence seizures. Carbamazepine, oxcarbazepine, vigabatrin, and tiagabine are contraindicated in the treatment of absence seizures. 17 The GABA agonists vigabatrin and tiagabine can induce absence seizures, including absence status epilepticus. 17 Carbamazepine also acts at GABA A receptors, which play a role in thalamic neuron firing, leading to an increased Learn about the use of gabapentin in the treatment of absence seizures, a type of epilepsy characterized by brief episodes of unconsciousness and staring spells.
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