This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Iannetti, P.
Right arrow Articles by Bizzarri, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Iannetti, P.
Right arrow Articles by Bizzarri, B.
Related Collections
Right arrow Therapeutics & Toxicology

PEDIATRICS Vol. 106 No. 4 October 2000, pp. 838-842

EXPERIENCE AND REASON:
Visual Field Constriction in Children With Epilepsy on Vigabatrin Treatment

Received Sep 29, 1999; accepted Jan 18, 2000.

Paola Iannetti*, Alberto Spalice*, Francesco Massimo Perla*, Elena Conicella*, Umberto Raucci*, and Barbara BizzarriDagger

* Pediatric Neurology, Department of Pediatrics Dagger  Ophthalmology Department La Sapienza University 00161 Rome, Italy

Vigabatrin is considered the drug of choice for infantile spasms and simple and complex partial epilepsy in childhood. Its mechanism of action relies on the irreversible inhibition of gamma -aminobutyric acid (GABA) transaminase. Since June 1997 several articles have been published reporting visual field constriction in adult patients on vigabatrin therapy. Recently, 7 pediatric patients, 1 on vigabatrin monotherapy and 6 on add-on therapy with visual field constriction have been described. We have observed 30 pediatric patients with epilepsy (14 boys and 16 girls), ages ranging from 4 to 20 years (mean: 11 years and 2 months) treated with vigabatrin for infantile spasms, simple and complex partial epilepsy, who had never complained of ophthalmologic disturbances. Twenty-one patients underwent complete routine ophthalmologic examination (fundus oculi, visual acuity, intraocular pressure, and visual field tests); 9 children (<6 years old) underwent only fundus examination, because collaboration was lacking. We report on 4 children showing constriction of visual field, prevailing in nasal hemifield. In 1 child, visual abnormalities were stable even 10 months after vigabatrin discontinuation, while in another a greater improvement was observed 5 months after discontinuation. The possible mechanisms have been discussed and the cone dysfunction, connected with GABA augmentation in the outer retina, has been outlined. We suggest a possible protocol to control visual abnormalities in epileptic children.

 Key words:  visual field, vigabatrin, epilepsy.




This article has been cited by other articles:


Home page
 IOVSHome page
R. Werth and G. Schadler
Visual field loss in young children and mentally handicapped adolescents receiving vigabatrin.
Invest. Ophthalmol. Vis. Sci., July 1, 2006; 47(7): 3028 - 3035.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
R. Riikonen
Topical Review: Infantile Spasms: Therapy and Outcome
J Child Neurol, June 1, 2004; 19(6): 401 - 404.
[Abstract] [PDF]

Home page
 NeurologyHome page
M. T. Mackay, S. K. Weiss, T. Adams-Webber, S. Ashwal, D. Stephens, K. Ballaban-Gill, T. Z. Baram, M. Duchowny, D. Hirtz, J. M. Pellock, et al.
Practice Parameter: Medical Treatment of Infantile Spasms: Report of the American Academy of Neurology and the Child Neurology Society
Neurology, May 25, 2004; 62(10): 1668 - 1681.
[Abstract] [Full Text] [PDF]