Beneficial cognitive effect of lamotrigine in severe acquired brain injury: A case report
Date
2021
Authors
Ng, Maxwell
Ali, Sheliza
Sue, Joanna
Cullen, Nora
McCullagh, Scott
Perera, Gihan
Hosseini, Hossein
Muniz-Rodriguez, Flor
Deng, Zhihui
Journal Title
Journal ISSN
Volume Title
Publisher
Interdisciplinary Neurosurgery
Abstract
Background: Acquired brain injuries (ABI) can cause various negative sequelae, including cognitive impairment,
leading to poor functional outcomes for patients. Evidence is limited on pharmacological interventions to
effectively improve the cognitive status of these patients. This study aims to provide evidence for the use of
lamotrigine to improve the cognitive status of patients with severe ABI.
Case presentation: We report the case of a 29-year-old man who suffered a severe traumatic brain injury secondary
to a motor vehicle collision. When admitted to our rehabilitation program three months later, he was in a
minimally conscious state, achieving Level III on the Rancho Los Amigos Cognitive Scale. Post-traumatic seizures
were well controlled with levetiracetam. Multiple neurostimulants including methylphenidate, amantadine, and
venlafaxine were trialed with minimal benefit, thereby prompting the switch of his antiepileptic medication to
lamotrigine five months after his injury. The introduction of lamotrigine was followed by relatively rapid and
significant improvement in arousal, cognition and communication that preceded levetiracetam being tapered.
The patient continued making functional gains over the following year while using lamotrigine.
Conclusions: Lamotrigine may potentially provide cognition-enhancing effects independent of its known antiepileptic
properties in patients with severe ABI. Further research is required on the role of lamotrigine in patients
with ABI.
Description
Keywords
Acquired brain injury, Lamotrigine, Cognitive impairment, Rehabilitation, Functional outcome
Citation
Ng, M., Ali, S., Sue, J., Cullen, N., McCullagh, S., Perera, G., … Deng, Z. (2021). Beneficial cognitive effect of lamotrigine in severe acquired brain injury: A case report. Interdisciplinary Neurosurgery, 25, 1-5. https://doi.org/10.1016/j.inat.2021.101186.