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Abstract

Background: Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy characterised by various types of generalised seizures, a noticeable deceleration in intellectual development, and a distinct EEG pattern. Those afflicted with LGS may have previously experienced infantile spasms or an underlying brain condition, though in some cases, the exact cause may be unknown (idiopathic). LGS seizures frequently resist conventional treatment, and the long-term prognosis is poor. Case Presentation: We present two Lennox-Gastaut syndrome cases. The first is a 3-year-old female who was diagnosed with brachycephaly at 3-months-old. Her initial EEG at 4-months-old revealed moderate right frontopolar hypofunction then a month later she underwent physiotherapy, and was prescribed valproic acid. At 2-year- old, the MRI displayed bilateral parieto-occipital cerebral atrophy and the EEG showed general slow-wave abnormalities in the left frontal region then the levetiracetam was added for her treatment. At the age of 2.5- year-old, levetiracetam was substituted by clobazam because the seizure didn’t improve so that the patient got combination therapy of valproic acid and clobazam, and then the seizure decreased after the substitution therapy. The second case is a 3-year-old girl who was diagnosed with hypocalcaemia at the age of 2 weeks. Three months later, she was diagnosed with epilepsy and the brain CT scan showed encephalomalacia, microcephaly and cerebral atrophy. At the age of two she was eventually diagnosed with Lennox-Gastaut syndrome with a particular EEG showing general slow-wave abnormalities. Initially she was treated with valproic acid and phenobarbital. Since there was no improvement of the seizure frequency, levetiracetam was added and phenobarbital was substituted by clobazam, which fortunately cause better condition.


Discussion: The cases highlight the challenges of managing LGS, which tends to be drug-resistant and associated with developmental delays and cognitive impairment. They underscore the need for a multidisciplinary approach to optimize care and enhance the patient's quality of life. This report serves as a reminder of the complexity of LGS and the importance of customizing treatment strategies to meet the unique needs of each patient.

Keywords

Epileptic, Lennox Gastaut, Treatment

Article Details

References

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