There are several treatment options, including medications, surgery, and diet. Medications In most patients with LGS, the treatment does not end seizure recurrence. The goals of treatment are to lower frequency and severity of seizures to greatest extent possible. There are no studies using only one medication. Lamotrigine and rufinamide used as add-ons are very effective in reducing overall seizures, but do not stop them. The treatments for LGS has evolved over the years. Various treatments have been shown to have some degree of efficacy. In 1997–1999, lamotrigine was found to be effective and approved by the Food and Drug Administration and Health Canada. In 1999, topiramate trials showed that topiramate decreased seizure occurrence by more than 50%. Felbamate is the treatment of last resort in the event that everything else fails, and was found to be superior to placebo in controlling treatment resistant partial seizures and atonic seizures. However, it has been known to cause aplastic anemia and liver toxicity. First-line drugs * valproate (valproic acid, sodium valproate and valproate semisodium) Second-line drugs * lamotrigine Third-line drugs * rufinamide * topiramate Treatment of last resort * felbamate Adjuvant drugs Are the following: * benzodiazepines, specifically clonazepam, nitrazepam, and clobazam * zonisamide * cannabidiol Surgery In the past, LGS patients were not eligible for surgery, as the medical community thought the LGS involved the whole brain as a generalized epilepsy in all cases. Since 2010, this assumption has been challenged. Two studies on LGS patients series who underwent curative surgery in Korea and China, showed very good results, up to seizure freedom for 80% of these patients below 5 years old, and 40% above 5 years old. Like all epilepsy curative surgeries, seizures may recur in the years following surgery, but surgery allows the child to have better brain development during the seizure free period. There are several procedures that have shown efficacy: * vagus nerve stimulation, which involves implantation of battery-operated generator of intermittent electrical stimuli to an electrode wrapped around left vagus nerve. Some studies have been shown it to have greater than 50% reduction in seizures reported in more than half of patients. * corpus callosotomy, which has shown to be effective with atonic seizures. This procedure is considered in cases in which vagus nerve stimulation has failed * transcranial direct current stimulation * resection Diet A ketogenic diet is a diet that causes ketosis, a state in which there is an increased amount of ketones in the body. Adopting and maintaining rigid diet may be difficult for some families. Short-term ketogenic diet might be associated with nonsignificant decreases in frequency of parent-reported seizures in children with LGS. A case series study showed 50% seizure reduction reported in almost half of children with LGS after 1 year of ketogenic diet. However, the strength of the study is challenged because it represents reports rather than scientific analysis of the clinical outcomes such as in a randomized controlled trial.
Lennox–Gastaut syndrome
Goldenhar syndrome
Joubert syndrome
Bardet–Biedl syndrome
Shprintzen–Goldberg syndrome
Benjamin syndrome
Christianson syndrome
Laron syndrome