Stimulating consciousness and cognition following severe brain injury: a new potential clinical use for lamotrigine

No medications clearly enhance consciousness or cognition following severe brain injury. This series (n = 13) suggests that lamotrigine may stimulate improvement of patients with impairment equivalent to level I-III on the Rancho Los Amigos Cognitive Scale. After a serendiptious clinical result, severely brain injured patients who were taking an anticonvulsant had an opportunity to start lamotrigine. This cohort had been transferred to this rehabilitation unit 14-304 (mean 73.9) days and started lamotrigine 20-310 (mean 87.5) days after acute brain injury. Compared to this unit's experience with patients with similar severe brain injuries, more patients (n = 10) were discharged to the conmmunity and fewer to skilled nursing facilities (n = 3) than were expected. This preliminary and provocative case series corresponds to basic science results, and further investigation of lamotrigine is warranted.