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Seizure. 2016 Nov;42:20-28. doi: 10.1016/j.seizure.2016.09.004. Epub 2016 Sep 22.

Intravenous lacosamide in seizure emergencies: Observations from a hospitalized in-patient adult population.

Author information

1
Epilepsy Centre - Clinic of Nervous System Diseases, University of Foggia, Riuniti Hospital, Foggia, Italy. Electronic address: giudorsi@yahoo.it.
2
Epilepsy Centre - Clinic of Nervous System Diseases, University of Foggia, Riuniti Hospital, Foggia, Italy.
3
Epilepsy Centre - Clinic of Nervous System Diseases, University of Foggia, Riuniti Hospital, Foggia, Italy; Department of Neurosciences, Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Abstract

PURPOSE:

to evaluate the efficacy and safety of intravenous (IV) lacosamide (LCM) in the treatment of seizure clusters (SC) and status epilepticus (SE) in hospitalized adult patients.

METHODS:

we prospectively analyzed treatment response, seizure outcome, and adverse effects of IV LCM in 38 patients with seizure emergencies (15 with SC, 23 with SE) during a hospital stay. The loading dose of IV LCM was 200-400mg and the maintenance dose was 200-400mg daily. Response to IV LCM was evaluated within 20min, 4h and 24h of LCM infusion.

RESULTS:

an acute anti-seizure effect after IV LCM was especially evident when it was first used - (SC) or second line (established SE) treatment. In particular, 87% of SC patients (13/15) and 80% of established SE (8/10) demonstrated response to LCM treatment, while no patients with super-refractory SE (0/8) responded to IV LCM according to our criteria. The loading of IV LCM was well tolerated, with mild adverse effects (2/38 temporary dizziness). In most patients, during and after administration of the loading dose of IV LCM a temporary (30min-1h) sedation was observed. No ECG and laboratory values-changes were documented in any of the patients.

CONCLUSIONS:

LCM is an effective and well-tolerated treatment when used to treat SC in hospitalized adult patients. As add-on therapy, it may be useful to stop seizure activity in patients with focal SE not responding to first/second-line intravenous AEDs.

KEYWORDS:

Hospitalized adult population; Lacosamide; Seizure clusters; Seizure emergencies; Status epilepticus; Video-EEG monitoring

PMID:
27693808
DOI:
10.1016/j.seizure.2016.09.004
[Indexed for MEDLINE]
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