lamotrigine liquid oral suspension / OWP Pharma - LARVOL DELTA

Phosphodiesterase-4 Inhibition: An Experimental Approach to Overcome Drug Resistance in a Rotenone-Corneal 6 Hz Kindling Mouse Model of Drug-Resistant Epilepsy. (PubMed, Mol Neurobiol) - "Standard anti-seizure medications (ASMs) such as pregabalin, levetiracetam, carbamazepine, phenytoin, and lamotrigine were used for resistance validation. Roflumilast as PDE4 inhibitor significantly manage DRE as evidenced by reducing seizure severity, improving cognitive functions and restoring neurochemical alterations. Its ability to modulate oxidative stress and provide neuroprotection in RCK mice underscores its promise as a novel adjunct treatment for DRE."

Journal • Preclinical • CNS Disorders • Epilepsy • Inflammation • CAT

Benign episodic unilateral mydriasis and headache: More than meets the eye (EHF-EHC 2025) - "Indomethacin and oral corticosteroids were not useful. Lamotrigine 100mg BD resulted in resolution of the pain, but with ongoing episodes of mydriasis...Contrast-enhanced MRI and MRA brain imaging showed incidental prominent optic nerve sheaths and intrasellar arachnoid herniation (without clinical signs of papilloedema) bilaterally, but no other relevant findings. These two cases highlight the likely association of headache with BEUM, suggesting possible shared biological pathways."

CNS Disorders • Migraine • Musculoskeletal Pain • Ophthalmology • Pain

Trigeminal neuralgia secondary to giant saccular aneurysm/endovascular procedure – Is lidocaine block an old treatment with a new indication? (EHF-EHC 2025) - "Carbamazepine is the standard first-line treatment, although alternatives such as oxcarbazepine, lamotrigine, or pregabalin may be considered in cases of intolerance or poor response...Due to poor control of pain (15 episodes/month) and intolerance to carbamazepine (ataxia, vertigo), eslicarbazepine was introduced. Trials with oxcarbazepine, lamotrigine, pregabalin, and levetiracetam were ineffective and poorly tolerated...Given the refractoriness of symptoms, the patient was submitted to peripheral nerve block with 2% lidocaine at the auriculotemporal and supraorbital branches, resulting in marked improvement and a >50% reduction in frequency and severity of attacks. Peripheral nerve block with lidocaine is a safe, accessible, and effective option for symptom relief and should be considered in cases of secondary trigeminal neuralgia refractory to pharmacological treatment."

Ataxia • Brain Cancer • Cardiovascular • Movement Disorders • Musculoskeletal Pain • Neuralgia • Otorhinolaryngology • Pain • Solid Tumor • Vertigo

Migraine and visual snow syndrome: Exploring shared pathways through hallucinogen-induced perceptual disturbances (EHF-EHC 2025) - "She showed no improvement with lamotrigine or gabapentin but responded to valproate 250 mg and cognitive behavioral therapy. In migraine, a lowered thalamic threshold may promote visual symptoms, further exacerbated by hallucinogens. These cases suggest overlapping pathophysiological mechanisms between VSS and hallucinogenic effects, highlighting the thalamus as a key structure involved in both conditions."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Endocrine Disorders • Migraine • Ophthalmology • Pain • Polycystic Ovary Syndrome • Retinal Disorders

Pre-Ictal Asystole in Refractory Epilepsy: A Video Case Report (AES 2025) - "Medications included lacosamide and lamotrigine...The patient was discharged on Perampanel 4 mg daily, and according to the parent's report on a follow up visit, there has been significant improvement, with no new seizures of any type observed. Our case is unique given a long pre-ictal asystole, as most literature regarding ictal asystole suggests it occurs at or following ictal onset... Our case is unique given a long pre-ictal asystole, as most literature regarding ictal asystole suggests it occurs at or following ictal onset. While the asystole in our case occurred during lab draws, the preceding junctional rhythms and pauses suggest a more complex interplay between autonomic instability and this seizure's onset rather than vasovagal response. Also, lack of EEG changes prior to and during asystole suggest against hypoperfusion-induced seizure."

Case report • Clinical • Video • Cardiovascular • CNS Disorders • Epilepsy

Cenobamate and Brivaracetam Use in Pregnancy and Lactation - A Case Report (AES 2025) - "She previously failed multiple ASMs, including clonazepam, gabapentin, oxcarbazepine, levetiracetam, lamotrigine, zonisamide, and phenytoin, due to inadequate seizure control or intolerable side effects. This case describes a normal pregnancy outcome in a young female with intractable localization-related epilepsy on combination cenobamate and brivaracetam. To our knowledge, this is the first reported pregnancy outcome with this specific ASM combination. This offers reassuring, preliminary evidence that cenobamate and brivaracetam may be safely continued in pregnancy when benefits outweigh risks, especially in intractable epilepsy."

Case report • Clinical • Anesthesia • CNS Disorders • Epilepsy

Allosteric inhibition of phosphodiesterase 4B as a broad-spectrum therapeutic strategy for refractory epilepsy (AES 2025) - "Standardized doses (50 mM) of SN-2000, standard-of-care ASMs (valproic acid [VPA], carbamazepine [CBZ], levetiracetam (LEV), lamotrigine [LTG], VPA + clobazam [CLO]) or vehicle were added to zebrafish media, and seizure-like locomotor activity was quantified using established automated behavioral tracking methods.2Maximal Electroshock (MES) seizure stimulation was performed on C57BL6/129 (WT) mice following oral gavage of SN-2000 40, 60, or 80 mg/kg, VPA 250 mg/kg or vehicle. These findings support PDE4B inhibition as a disease-relevant mechanism in epilepsy and highlight SN-2000 as a promising broad-spectrum anti-seizure therapeutic candidate. SN-2000 demonstrates potential pro-cognitive and behavioral benefits beyond those of available ASMs.1Kinch et al. AES 2024; 2.3492Ibhazehiebo et al., Brain."

CNS Disorders • Epilepsy • Mood Disorders • Psychiatry

Efficacy and Tolerability of RAP-219, a Potential First-in-Class Negative Allosteric Modulator of γ8 Transmembrane AMPA Receptor Associated Protein: Impact on RNS Long Episodes and Focal Seizures (AES 2025) - "Use of perampanel was exclusionary...The most common ASMs were lamotrigine, cenobamate, levetiracetam, zonisamide, and clobazam... The baseline characteristics of the patients enrolled in this innovative POC study testing the electrographic and clinical effect of RAP-219 in RNS patients with FOS are similar to those reported in contemporary Phase 2 and 3 studies. Efficacy, safety, and tolerability of RAP-219 (to be reported) as evaluated during the 8-week, open-label treatment trial are expected to be highly relevant to patients with drug-resistant FOS."

Clinical • Late-breaking abstract • CNS Disorders • Epilepsy

Epilepsy and Neurodevelopmental Disorders Associated with ASH1L mutations: A Natural History Study of Genotype-Phenotype Correlation (AES 2025) - "Seizures responded to broad spectrum anti-seizure medications (ASMs), mostly with mono- or dual therapy, including Ethosuximide, Valproate, Lamotrigine, Levetiracetam, Clobazam. Our study has demonstrated a higher prevalence and worse phenotypic severity of epilepsy, in female patients with ASH1L mutations, which may implicate sex-specific epigenetic mechanisms of ASH1L in epileptogenesis."

Late-breaking abstract • Neurodevelopmental • Absence Seizure Disorder • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Mental Retardation • Psychiatry • Tic Disorders • Tourette Syndrome • ASH1L

Hidden in Decline: Epilepsy in Neurodegenerative Disorders and the Case for Integrated Care (AES 2025) - "ASMs such as levetiracetam and lamotrigine have shown promise in controlling seizures while preserving cognition, suggesting dual therapeutic potential. Older ASMs (e.g., phenytoin, valproate) are linked to cognitive decline, metabolic effects, and valproate-induced parkinsonism... Integrated diagnostic and therapeutic approaches are critical to address the burden of epilepsy in NDDs. Future research should prioritize: (1) implementing standardized seizure screening in NDDs to reduce misattribution of seizures to disease progression, (2) characterizing the bidirectional influence of epilepsy and neurodegeneration on cognition, (3) identifying safe and effective ASMs, and (4) developing disease-modifying therapies addressing shared mechanisms. Device-based therapies (e.g., vagus nerve stimulation, responsive neurostimulation, deep brain stimulation) and dietary approaches (e.g., ketogenic therapy) also warrant evaluation."

Clinical • Alzheimer's Disease • CNS Disorders • Dementia • Epilepsy • Frontotemporal Lobar Degeneration • Lewy Body Disease • Movement Disorders • Parkinson's Disease

Relationship of Maternal RBC Folate Levels to MONEAD Age 6 Neuropsychological Outcomes (AES 2025) - "Enrolled WWE during pregnancy were primarily on monotherapy or polytherapy with lamotrigine or levetiracetam. Our findings demonstrate no relationship of maternal RBC folate levels in early or in all of pregnancy with verbal and behavioral measures at age 6yo. Positive effects may not have been seen due to only one mother below the recommended RBC folate level. Further, there was no evidence of risk from higher RBC folate levels."

CNS Disorders • Epilepsy

Clinical Signature and Longitudinal Seizure Pattern of SLC6A1-Related Neurodevelopmental Disorder (AES 2025) - "The most common ASMs used were valproic acid (59%, 13/22), levetiracetam (59%, 13/22), lamotrigine (50%, 11/22), ethosuximide (45%, 10/22), and clobazam (41%, 9/22). This study represents a large longitudinal investigation of SLC6A1-related epilepsy. The natural history of seizures seen in this cohort demonstrates a unique pattern of seizure onset that contrasts with patterns previously described in STXBP1, SYNGAP1, and SCN8A (McKee et al. 2024, medRxiv)."

Clinical • Neurodevelopmental • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Gastrointestinal Disorder • Genetic Disorders • Mental Retardation • Movement Disorders • Psychiatry • SCN8A • XBP1

Idiopathic generalized epilepsies exacerbated by sodium channel blockers: a 10-case analysis for the reasons and consequences of misuse (AES 2025) - "Oxcarbazepine was prescribed to 7 patients and was the first ASM in 2 patients, carbamazepine to 2 patients and lacosamide to 1 patient...There was also EEG worsening, including multifocal spikes in 8 and fast rhythmic activity in 6 cases.Discontinuation of SCBs and optimization of ASMs to valproate, lamotrigine, levetiracetam, perampanel or clobazam resulted in seizure control in 9 patients after a median time of 9.5 months... SCBs exacerbate seizures and EEG abnormalities in IGEs. Focal EEG features and atypical semiology can lead to the misuse of SCBs. Adherence to IGE treatment guidelines, which involve avoiding SCBs and prioritizing broad-spectrum ASMs, is essential to prevent disease progression and reduce the healthcare burden."

Clinical • Absence Seizure Disorder • CNS Disorders • Epilepsy

Hormone Therapy and Seizure Management in Transgender Individuals With Epilepsy: Insights From a Retrospective Review' (AES 2025) - "Five TF patients experienced a drop in lamotrigine (LTG) levels during E therapy, particularly when GnRH agonists or E injections were used...One TF patient had stable LTG levels on an E patch, but levels dropped after switching to oral E. Two TF patients showed a linear increase in levetiracetam levels with rising E levels. Two TF patients on phenytoin (PHT) experienced decreased PHT levels after a sudden E increase—one due to GnRH therapy and the other after starting E injections. Our study reveals potential interactions between gender-affirming hormone therapy and ASMs, with changes in drug levels linked to hormone type and administration route... Our study reveals potential interactions between gender-affirming hormone therapy and ASMs, with changes in drug levels linked to hormone type and administration route. These findings highlight the need for careful monitoring of ASM levels and individualized management in transgender individuals with epilepsy. However,..."

Retrospective data • Review • CNS Disorders • Endocrine Disorders • Epilepsy

Survey of Birth Control Practices in People with Epilepsy of Child-bearing Potential (PWECP) – Single Center Data (AES 2025) - "9/102 (8.8%) participants reported using contraception to prevent seizures.The most common antiseizure medications used were levetiracetam, 54/102 (52.9%), and lamotrigine 35/102 (34.3%) (Table 2). These results suggest that there are gaps in contraception counseling and awareness among PWECP. OCPs are the most commonly used contraceptive in PWECP as well as the NSFG. Use of depot medroxyprogesterone acetate and etonogestrel implants was higher in our sample than in the NSFG.This project will be expanded to multiple sites across the United States to obtain large-scale data."

Clinical • CNS Disorders • Epilepsy • Long-acting Reversible Contraceptives

Do Focal Reticulothalamocortical Seizures Exist? (AES 2025) - "EEGs revealed many hours of long runs of temporal and diffuse spikes and spike wave patterns as described below, despite being clinically seizure free on levetiracetam 2500 mg twice daily and lamotrigine twice daily. The true nature of the epileptogenic network remains uncertain, however, the lack of clinical and radiographic excitotoxicity despite hours-long runs of ictal-appearing temporal discharges in combination with generalized spike and polyspike wave patterns raises the hypothesis of a unique epileptiform generator with some similarity to absence and myoclonic-absence seizures that often activates only regionally. Continued surveillance of her mesial temporal structures, memory, mood as well as genetic testing may further illuminate this case."

Late-breaking abstract • Absence Seizure Disorder • CNS Disorders • Epilepsy

Adult Diagnosed Dravet Syndrome: Challenges and Opportunities (AES 2025) - "DS was diagnosed in three patients, one of whom is three years seizure free after withdrawal of lamotrigine...Due to recurrent and prolonged myoclonic-tonic-clonic seizures, his rescue medication was changed from benzodiazepines to buccal fosphenytoin which has effectively reduced the frequency of status epilepticus. Genetic testing should be considered in all adults with unexplained DRE and ID... Genetic testing should be considered in all adults with unexplained DRE and ID. When an SCN1A variant is identified, it is important to consider the phenotype, the variants pathogenicity and its function. These cases highlight the significant impact on seizure control and quality of life that a change in SCB's can have, even in adults."

Clinical • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Movement Disorders • Parkinson's Disease

Title: Focal Cortical Dysplasia as a Novel Neuroimaging Finding in ARID1B-related Disorders (AES 2025) - "At last follow-up at 17 years of age, seizures were well-controlled on lamotrigine monotherapy. We present two individuals with ARID1B-RD, epilepsy, and multifocal FCDs, a previously unreported MRI finding in ARID1B-RD... We present two individuals with ARID1B-RD, epilepsy, and multifocal FCDs, a previously unreported MRI finding in ARID1B-RD. For one patient, the identification of the FCDs led to surgery with subsequent seizure freedom. For the second patient, EEG was suggestive of a generalized epilepsy and seizures are well-controlled."

CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Psychiatry • Strabismus • ARID1B

Lamotrigine Restores Impairments in Theta Rhythms and LTP as Early Biomarkers of Aβ1-42-Induced Hippocampal Network Dysfunction. (PubMed, Aging Dis) - "We found that: i) Aβ1-42 ICV infusions led to significant reductions in theta amplitude and power on days 7 and 14, with a complete loss by day 21; ii) LTG restored LTP and theta rhythms in terms of power and amplitude in HPC obtained from Aβ1-42-treated animals 14 days post-ICV infusion; iii) histological analysis confirmed neurodegeneration, Tau hyperphosphorylation, astrogliosis, increased number of parvalbimun positive (PV+) interneurons, and GluN2B receptor upregulation in HPC of Aβ1-42-treated animals 14 days post-ICV infusion. These findings suggest that hippocampal theta disruption may serve as an early biomarker of network dysfunction in sAD, and that LTG-mediated partial restoration of theta and LTP offers a potential early therapeutic strategy."

Biomarker • Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Epilepsy • GRIN2B

No Light at the End of the Tunnel: Closing a Mucosal Defect from Inside the Tunnel During G-POEM Procedure (ACG 2025) - "We report a case of gastric POEM (GPOEM) with a mucosal defect closure from inside the tunnel due to difficult luminal side closure.Case Description/ A 48-year-old female with gastroparesis (gastric emptying study with 68% retention at 4 hours) with abdominal pain after eating, epigastric fullness, early satiety, bloating, nausea with rare vomiting, not feeling hungry, and 60 lbs weight loss over two years underwent GPOEM due to concern about long term neurological side effects with metoclopramide in the setting of lamotrigine use for bipolar disorder. Panel C: closure of the mucosal defect from inside the tunnel using two clips. Panel D: abdominal X-ray 3 months later showing only one clip in the gastric outlet/duodenal bulb area."

Bipolar Disorder • CNS Disorders • Gastrointestinal Disorder • Infectious Disease • Psychiatry

STEVENS-JOHNSON SYNDROME AND THE CONSEQUENCES OF PLACEMENT (CHEST 2025) - "Drug intolerance causes>50% of cases, including sulfa antibiotics, allopurinol, lamotrigine, NSAIDs, and some chemotherapy agents (4)...Treatment involves stopping the offending medication, providing supportive care, and treating with cyclosporine or plasmapheresis...She began adjuvant chemotherapy with gemcitabine and capecitabine and three weeks later developed oral ulcers, truncal rash, and diarrhea... This case highlights the need for appropriate clinical decision-making to play a more significant role in determining which patients clinically fit the profile of a severe case of SJS. Comorbidities like chemotherapy exposure should considered when deciding how to triage patients' care appropriately."

Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Conjunctivitis • Dry Eye Disease • Gallbladder Cancer • Hematological Disorders • Ocular Infections • Ocular Inflammation • Ophthalmology • Solid Tumor • Steven-Johnson Syndrome • Thermal Injury • CCL22

Limb Myorhythmia in a Patient With Anti-LGI-1 Encephalitis (MDS Congress 2025) - "She was treated with intravenous methylprednisolone and IVIG, alongside Lamotrigine and Levetiracetam, resulting in seizure freedom. Although myorhythmia is frequently misdiagnosed as tremor or clonus, it is crucial to distinguish it from seizures (e.g epilepsia partialis continua), particularly in patients with a prior history of seizures secondary to encephalitis, as this distinction can have important treatment implications. Notably, a slower velocity and the disappearance of activity during sleep can be helpful distinguishing clues. This case highlights that limbic encephalitides can lead to atypical movement disorders in such patients."

Clinical • CNS Disorders • Epilepsy • Movement Disorders

Spinocerebellar Ataxia 17 Presenting with Childhood Seizures and Mesial Temporal Lobe Sclerosis (MDS Congress 2025) - "He was treated with levetiracetam and lamotrigine and did not pursue epilepsy surgery...Dopamine transporter scan (DATSCAN) was normal and he had no response to an empiric trial of carbidopa/levodopa... The presented case suggests that 41 CAG/CAA trinucleotide expansion can be considered a critical threshold in SCA17. We suggest that SCA 17 should be suspected in patients with movement disorders associated with epilepsy. While seizures may be part of the SCA 17 phenotype, we are not aware of any reports in the literature demonstrating mesial temporal sclerosis with hippocampal atrophy in this disease."

Clinical • Ataxia • CNS Disorders • Dystonia • Epilepsy • Movement Disorders

A Case of "Rabbit" Syndrome with Concomitant Tongue Tremor (MDS Congress 2025) - " N/A A 58-year-old Hispanic female with a history of restless leg syndrome (RLS) on ropinirole and depression on aripiprazole, lamotrigine, and paroxetine initially presented for worsening RLS...Ropinirole was replaced with pregabalin with marked improvement in RLS symptoms...Movements significantly improved after starting carbidopa/levodopa... The movement pattern of the lips in this patient is consistent with the known phenomenology of "rabbit" syndrome. However, the concomitant re-emergent tongue is atypical with this syndrome and it is more commonly a feature of Parkinson's disease tremor. Given the possible shared mechanism between RS and DIP, this case may represent a co-occurring phenomenon or support RS being part the DIP spectrum."

Clinical • Preclinical • CNS Disorders • Depression • Movement Disorders • Parkinson's Disease • Psychiatry • Restless Legs Syndrome • Sleep Disorder

COMPREHENSIVE ASSESSMENT OF THE RISKS OF MENTAL DEVELOPMENT DISORDERS IN CHILDREN BORN TO MOTHERS WITH EPILEPSY (WCN 2025) - "There were the multifactorial nature of the influence of maternal epilepsy on the further mental development of the child."

Clinical • CNS Disorders • Epilepsy