Nicotine as an Antiepileptic Agent in ADNFLE: An N‐of‐One Study

• Published in: Epilepsia (Copenhagen) Vol. 44; no. 9; pp. 1238 - 1240
• Main Authors: Willoughby, John O., Pope, Kenneth J., Eaton, Vaughn
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148 , U.S.A Blackwell Science Inc 01.09.2003; Blackwell
• Subjects: Administration, Cutaneous; Adult; Anticonvulsants - administration & dosage; Anticonvulsants. Antiepileptics. Antiparkinson agents; Autosomal dominant nocturnal frontal lobe epilepsy; Biological and medical sciences; Double-Blind Method; Epilepsy, Frontal Lobe - drug therapy; Epilepsy, Frontal Lobe - genetics; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Medical sciences; Mutation; Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; Nicotine - administration & dosage; Pharmacology. Drug treatments; Treatment; Human; Treatment-Autosomal dominant nocturnal frontal lobe epilepsy; Nervous system diseases; Anticonvulsant; Frontal lobe epilepsia; Cerebral disorder; Genetic disease; Case study; Alkaloid; Chemotherapy; Treatment; Autosomal character; Central nervous system disease; Dominant character; Patch; Nicotine
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1046/j.1528-1157.2003.58102.x-i1

Purpose: To test nicotine patch treatment for a patient with a defined mutation for autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) whose seizures were refractory to standard antiepileptic therapy. Methods: Open and double‐blind trials of nicotine patches in an “n‐of‐one” study. The double‐blind trial comprised periods during which either placebo or nicotine patches were each used for three periods of 2 weeks, randomized in a double‐blind manner. Results: In an open study, nicotine patches reduced seizures from 1.65 ± 2.36 to 0.01 ± 0.0 seizures per day (p < 0.0001). In a double‐blinded placebo‐controlled phase, the average frequency of seizures on nicotine versus placebo was 0 ± 0 versus 0.56 ± 1.14 seizures per day (p < 0.0001). Conclusions: Nicotine patches may be of benefit to some individuals with ADNFLE.