Surveillance électrophysiologique des patients épileptiques traités par Vigabatrin

Vigabatrin is a GABA mimetic antiepileptic agent that has been used for 10 years in cases of epilepsy that resist other treatments. Since 1997, concentric visual field defects have been reported. Before any visual symptom complaint, they quickly become irreversible and highly disabling. To prevent this visual impairment, the monitoring protocol must be defined with reliable and well-supported tests, so that patients treated with Vigabatrin can be regularly monitored. Our purpose was to know if EOG impairments were frequent, if their severity was proportional to visual impairment, and if the Arden ratio could be a predictive criterion of Vigabatrin toxicity. Seventy-two patients treated with Vigabatrin for 2-10 years were examined, and EOG results were compared with a normal population EOG and then the patient's visual field. The monitoring protocol proposed includes EOG, which seems to be the most sensitive and specific diagnostic tool for screening Vigabatrin-treated patients.