Lacosamide as an adjunctive therapy in pediatric patients with refractory focal epilepsy
Jon Soo Kim1, Hunmin Kim2, Byung Chan Lim3
1Department of Pediatrics, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; Department of Pediatrics, Eulji University Hospital, Dae-jeon, Republic of Korea.
Insights
Lacosamide effectively treated pediatric refractory focal epilepsy in 67% of patients, with a notable seizure-free outcome in 10%. This epilepsy medication demonstrated good tolerability in children.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Pharmacology
Background:
- Refractory focal epilepsy presents significant treatment challenges in pediatric populations.
- Identifying effective and well-tolerated antiepileptic drugs is crucial for managing pediatric epilepsy.
Purpose of the Study:
- To assess the efficacy and safety of lacosamide as an adjunctive therapy for pediatric patients diagnosed with refractory focal epilepsy.
- Evaluate lacosamide's effectiveness in reducing seizure frequency and achieving seizure freedom in children.
Main Methods:
- Retrospective review of medical records for pediatric patients (<18 years) treated with oral lacosamide.
- Analysis of clinical data including epilepsy characteristics, concomitant antiepileptic drugs, lacosamide dosage, and treatment outcomes.
- Assessment of efficacy (responder status, seizure reduction) and safety (adverse events).
Main Results:
- Twenty-one pediatric patients (median age 13.9 years) with refractory focal epilepsy were included.
- Lacosamide treatment resulted in a 67% response rate, with 10% achieving complete seizure freedom.
- Adverse events led to discontinuation in 10% of patients; 38% experienced mild, transient side effects.
Conclusions:
- Lacosamide is a valuable therapeutic option for pediatric refractory focal epilepsy.
- The drug demonstrates significant efficacy and a favorable safety profile in this patient group.
- Lacosamide is well-tolerated and effective across a broad spectrum of pediatric refractory focal epilepsy cases.
Purpose:
To evaluate the efficacy and safety of lacosamide in pediatric patients with refractory focal epilepsy.
Methods:
We reviewed retrospectively the medical records of children younger than 18 years of age treated at Seoul National University Bundang Hospital, in whom oral lacosamide was used as an adjunctive treatment for refractory focal epilepsy. Clinical information regarding the patients' epilepsy and the outcome of lacosamide treatment was gathered and analyzed.
Results:
Twenty-one patients (16 boys, 5 girls) were included, with a median age of 13.9 (range, 1.2-17.9) years. The mean number of concomitant antiepileptic drugs was 3.0 (range, 1-6) and the mean duration of follow-up was 10.1 (range, 6.1-13.0) months. The mean maintenance dose of lacosamide was 5.4 (range, 1.4-9.8) mg/kg/day. Fourteen patients (67%) were responders; four of these were seizure free at the last follow-up. Seven patients (33%) were nonresponders: two of these presented with <50% seizure reduction and five showed no change in seizure frequency. Two patients (10%) discontinued oral lacosamide because of adverse events (aggressive behavior and depression). Mild transient treatment-related adverse events were observed in eight of the 21 patients (38%).
Conclusions:
Lacosamide represents a useful drug that is effective for a wide range of pediatric refractory focal epilepsy and is well tolerated.
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