Table I.
LGS group: clinical, therapeutic and electroencephalographic data.
| Case/sex | 1/M | 2/F | 3/F | 4/M | 5/M |
|---|---|---|---|---|---|
| Etiology | Structural (bilateral atrophy) | Unknown | Unknown | Unknown | Structural (PVL) |
| Age at onset of seizures (months) | 52 | 3 | 3 | 32 | 23 |
| Age at start of PT cycle (months) | 143 | 193 | 177 | 51 | 56 |
| Type of seizures | Spasms | Spasms | Spasms | Generalized (myoclonic-atonic) | GTCS |
| Neurological problems before epilepsy onset | Motor delay and aphasia | Motor delay and aphasia | Normal | Normal | CP |
| Previous AEDs | VPA, LTG, NZP, HC, RFN | VPA, NZP, RFN, PB, VGB, LTG, FBM, CBZ, CLB, CZP, ESM, TPM, LEV, ACTH | VPA, PB, VGB, LTG, LEV, CBZ, FBM, TPM, HC, LCM, CLB | CLB, VPA, LTG, LEV, RFN, ACTH | VPA, PB, TPM, RFN, ZNS, CLB, ACTH |
| AEDs at start of PT | VPA, LTG, NZP, RFN | VPA, NZP, RFN | VPA, LEV, TPM, FBM, CLB, LCM | VPA, LEV | PB, RFN, ZNS, CLB |
| EEG before PT | Awake and sleep: very frequent multifocal SWDs (>90%) | Awake: very frequent multifocal SWDs (>90%) Sleep: subcontinuous (>90%) SWDs |
Awake and sleep: SDs (frontal-parietal right>left) | Awake: very frequent SWDs (>80%) (bilateral) | Awake and sleep: bilateral slow activity and bilateral SDs |
| EEG after PT | Awake and sleep: modest reduction of multifocal SWDs (70%) | Awake: modest reduction of multifocal SWDs (70%). Sleep: significant reduction of SWDs (50%) |
Awake and sleep: moderate amplitude of SDs (5%) | Awake and sleep: dramatic reduction of SWDs (5%) | No change |
| Seizure frequency before PT | >50 seizures/month |
>50 seizures/month |
>50 seizures/month |
>50 seizures/month |
20–50 seizures/month |
| Seizure frequency after PT | 20–50 seizures/month |
20–50 seizures/month |
20–50 seizures/month |
Seizure free | No change |
Abbreviations: M=male; F=female; LGS=Lennox-Gastaut syndrome; EEG=electroencephalogram; PVL=periventicular leukomalacia; GTCS=generalized tonic-clonic seizures; CP=cerebral palsy; AEDs=antiepileptic drugs; PT=pulse therapy; SWDs=spike-slow wave discharges; SDs=spike discharges; VPA=valproic acid; NZP=nitrazepam; HC=hydrocortisone; PB=phenobarbital; VGB=vigabatrin; LTG=lamotrigine; FBM=felbamate; CBZ=carbamazepine; CLB=clobazam; CZP=clonazepam; ESM=ethosuximide; TPM=topiramate; LEV=levetiracetam; ACTH=adrenocorticotropic hormone; LCM=lacosamide; RFN=rufinamide; ZNS=zonisamide.