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--- content:vigabatrin [2020/02/23 18:01] – [Considerations in women] icna
+++ content:vigabatrin [2020/02/23 18:04] – [Main disadvantages] icna
@@ Line 56: / Line 56: @@
 ==== Main disadvantages ====
   * Visual field defects have virtually eliminated vigabatrin from common clinical practice except for infantile spasms
-  * Aggravation of seizures: vigabatrin is a pro-absence agent which aggravates absence seizures and provokes absence status epilepticus.14 This alone would prohibit use of vigabatrin in IGEs with absences.
+  * Visual field defects may not be clinically detectable. Therefore, patients should be monitored with perimetry prior to and every 6 months during vigabatrin treatment.
+  * Electrophysiological testing is considered to be more accurate than perimetry for the direct vigabatrin effect on the outer retina[(:cite:12588920>{{pubmed>12588920}})].The manufacturers provide a procedure for testing children.
+  * Aggravation of seizures: vigabatrin is a pro-absence agent which aggravates absence seizures and provokes absence status epilepticus[(:cite:9371946>{{pubmed>9371946}})].This alone would prohibit use of vigabatrin in IGEs with absences.
+  * Vigabatrin, may also exaggerate atypical absences (such as those occurring in Lennox–Gastaut syndrome) and myoclonic seizures (such as those occurring in progressive or non-progressive myoclonic epilepsies).
-Vigabatrin, in addition to its aggravation effect on typical absence seizures, may also exaggerate atypical absences (such as those occurring in Lennox–Gastaut syndrome) and myoclonic seizures (such as those occurring in progressive or non-progressive myoclonic epilepsies).
-Visual field defects may not be clinically detectable. Therefore, patients should be monitored with perimetry prior to and every 6 months during vigabatrin treatment. Electrophysiological testing is considered to be more accurate than perimetry for the direct vigabatrin effect on the outer retina.17The manufacturers provide a procedure for testing children.
 Numerous RCTs failed to detect common and serious visual field defects