Resolution of epileptic encephalopathy following treatment with transdermal nicotine
Version of Record online: 12 OCT 2012
Wiley Periodicals, Inc. © 2012 International League Against Epilepsy
Volume 54, Issue 1, pages e13–e15, January 2013
How to Cite
Zerem, A., Nishri, D., Yosef, Y., Blumkin, L., Lev, D., Leshinsky-Silver, E., Kivity, S. and Lerman-Sagie, T. (2013), Resolution of epileptic encephalopathy following treatment with transdermal nicotine. Epilepsia, 54: e13–e15. doi: 10.1111/j.1528-1167.2012.03715.x
- Issue online: 3 JAN 2013
- Version of Record online: 12 OCT 2012
- Accepted August 20, 2012; Early View publication October 12, 2012.
- Autosomal dominant nocturnal frontal lobe epilepsy;
- Nicotinic acetylcholine receptors;
- Refractory epilepsy
We report resolution of an epileptic encephalopathy by administration of transdermal nicotine patches in an adolescent with severe nonlesional refractory frontal lobe epilepsy. The 18.5-year-old female patient had refractory epilepsy from the age of 11. Recurrent electroencephalography (EEG) recordings showed mostly generalized activity, albeit with right frontal predominance. Almost all antiepileptic medications failed to provide benefit. She developed an encephalopathic state with cognitive decline. The nonlesional frontal lobe epilepsy and a family history of a cousin with nocturnal epilepsy with frontal origin suggested genetic etiology. Transdermal nicotine patches brought complete resolution of the seizures, normalization of the EEG, and a significant improvement in her thinking process and speech organization. Sequencing of the CHRNB2 and CHRNA4 genes did not detect a mutation. Transdermal nicotine patches should be considered in severe pharmacoresistant frontal lobe epilepsy.