IJCM  Vol.7 No.3 , March 2016
Epilepsy Properties and Seizure Suppression in a Severe Motor and Intellectual Disabilities
Abstract: Purpose: In hospitalized patients with severe motor and intellectual disabilities (SMID), we analyzed the association of the SMID class to factors such as the prevalence of epilepsy, frequency of seizures and number of concomitantly used anti-epileptic drugs (AEDs), and evaluated the usefulness of addition of the new AEDs (gabapentin, topiramate, lamotrigine and levetiracetam) to the treatment regimen. Results: The prevalence of epilepsy in the study population was about 60%. There were 39.5% who were free of epileptic seizures during the 6-year survey period and remained well-controlled with medication. As the SMID increased in severity, the frequency of seizures increased, the number of concomitantly used AEDs increased, and the tendency towards addition of new AEDs became more marked. About the use situation of new AED and old AED, this comparison revealed a tendency towards addition of a new AED when the seizures were poorly controlled in response to concomitant use of multiple old AEDs. The frequency of seizures and the number of concomitantly used AEDs were higher in patients with SMID of high severity than in those with SMID of low severity. Analysis of the time-course of the frequency of seizures before and after the addition of new AEDs revealed a significant reduction in the frequency of seizures following the addition of the new AEDs (P > 0.001). Conclusions: These results suggest that the new AEDs are useful in the management of SMID-associated epilepsy, because of their effect of reducing the frequency of SMID-associated seizures and their high tolerability.
Cite this paper: Morimoto, M. , Suzaki, I. , Satomura, S. , Shimakawa, S. , Naito, E. , Hashimoto, T. , Nakatsu, T. , Ito, E. and Kyotani, S. (2016) Epilepsy Properties and Seizure Suppression in a Severe Motor and Intellectual Disabilities. International Journal of Clinical Medicine, 7, 182-192. doi: 10.4236/ijcm.2016.73019.

[1]   Nakken, H. and Vlaskamp, C. (2007) A Need for a Taxonomy for Profound Intellectual and Multiple Disabilities. Journal of Policy and Practice in Intellectual Disabilities, 4, 83-87.

[2]   Bellamy, G., Croot, L., Bush, A., Berry, H. and Smith, A. (2010) A Study Define: Profound and Multiple Learning Disabilities (PMLD). Journal of Intellectual Disabilities, 14, 221-235.

[3]   Konishi, T. (2012) Severe Motor and Intellectual Disabilities and Epilepsy. Medical Treatment and Education of Severe Motor and Intellectual Disabilities, 7, 1-8.

[4]   Konishi, T. (2013) Severe Motor and Intellectual Disabilities (SMID) and Epilepsy. Epilepsy, 17, 113-117.

[5]   Miyazaki, S. (1996) The Present Conditions and Problems of the Epilepsy Treatment in Severe Motor and Intellectual Disabilities Facilities. Severe Motor and Intellectual Disabilities Study Bulletin, 21, 84-87.

[6]   Morimoto, M., Hashimoto, T., Shigeko, S., Sheishi, S., Kyotani S., et al. (2014) Investigation of Factors Contributing to the Current Status of Patients with Severe Motor and Intellectual Disabilities and the Relationships between Those Factors. Journal of Severe Motor and Intellectual Disabilities, 39, 387-395.

[7]   Wada, K. and Kaneko, S. (2008) The Present Conditions of the New Antiepileptic Drug. Brain Medical, 20, 27-30.

[8]   Project Team of Medical Survey by Severe Cerebral Palsy Child (2011) Medical Working Papers about the Convalescence of the Severe Cerebral Palsy Child. Japan Council for Quality Health Care, Tokyo.

[9]   Ooe, K. (2012) Study Trend Using the Physiological Index in Severeness and Disability Overlap Child. Special Support Education Center Study Bulletin, 4, 25-32.

[10]   Kawamura, T. and Hirose, G. (2008) An Elderly Person and Epilepsy. Epilepsy, 2, 109-113.

[11]   Hauser, WA. (1992) Seizure Disorders: The Changes with Age. Epilepsia, 33, S6-S14.

[12]   The Japanese Society of Child Neurology “Epilepsy Treatment Guidelines” Making Committee (2010) Epilepsy Treatment Guidelines 2010. Tokyo.

[13]   Ikeda, H., Sato, E., Kimura, Y., Miyake, K., Kitaura, T., et al. (2000) Change of the Drug Blood Concentration Measurement Business in the Hiroshima University Hospital for the Past 10 Years—Mainly on an Antiepileptic Drug. Journal of Japanese Society of Hospital Pharmacists, 36, 153-156.

[14]   Deckers, C.L., Genton, P., Sills, G.J. and Schmidt, D. (2003) Current Limitations of Antiepileptic Drug Therapy: A Conference Review. Epilepsy Research, 53, 1-17.

[15]   Yamada, M., Tokumasu, K., Shirai, Y., Yamamura, K. and Kasashige, K. (2014) Combination Therapy of Antiepileptic Drug Levetiracetam under the True Clinical Practice—Use Results Investigation into Levetiracetam for the Adult Epilepsy Patient Having a Partial Attack. A New Drug and Clinical Practice, 63, 301-324.

[16]   National Institute for Clinical Excellence (2012) The Epilepsies: The Diagnosis and Management of the Epilepsies in Adults and Children in Primary and Secondary Care. NICE Guideline 137. London.

[17]   Karceski, S., Morrell, M.J. and Carpenter, D. (2005.) Treatment of Epilepsy in Adults: Expert Opinion, 2005. Epilepsy & Behavior, 7, 1-64.

[18]   Arif, H., Buchsbaum, R. and Pierro, J. (2010) Comparative Effectiveness of 10 Antiepileptic Drugs in Older Adults with Epilepsy. Archives of Neurology, 67, 408-415.

[19]   Werhahn, K.J., Trinka, E. and Dobesberger, J. (2015) A Randomized, Double-Blind Comparison of Antiepileptic Drug Treatment in the Elderly with New-Onset Focal Epilepsy. Epilepsia, 56, 450-459.