Lamotrigine as a First-line Agent in the Management of Paroxysmal Kinesigenic Dyskinesia
Heather Leduc-Pessah1, Asif Doja2
1Children's Hospital of Eastern Ontario, Pediatric Neurology, 2CHEO
Objective:
To report the effectiveness of lamotrigine as a first line medication for PKD.
Background:
Brief episodes of involuntary movement triggered by purposeful actions are characteristic of paroxysmal kinesigenic dyskinesia (PKD) and can significantly interfere with daily life. Carbamazepine and oxcarbazepine are effective at reducing episodes but have teratogenic risks and adverse effects that limit their therapeutic potential. There is minimal evidence describing alternate sodium channel blockers as first line therapies for PKD.
Design/Methods:
A retrospective chart review of patients with PKD seen at our tertiary care centre between Jan 2013-June 2022.
Results:
Of eleven identified patients, two received lamotrigine as a first line medication. Lamotrigine, at a low dose, produced a complete resolution of episodes with no reported adverse effects. Both patients were on lamotrigine for >1 year.
Conclusions:
Lamotrigine is an effective first line alternative to carbamazepine and oxcarbazepine for PKD. It is a safer choice for females of child bearing potential and may have increased tolerability.