Efficacy and Tolerability of Lacosamide in the Treatment of Children With Refractory Generalized Epilepsy
Chandrabhaga Miskin1, Divya S Khurana1, Ignacio Valencia1
1Department of Pediatrics, Section of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA.
Insights
Lacosamide effectively reduces seizures in children with difficult-to-treat generalized epilepsy, especially those with Lennox-Gastaut Syndrome. The medication proved well-tolerated in this pediatric patient group.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Pharmacology
Background:
- Lacosamide is FDA-approved for partial-onset epilepsy in patients aged 17 and older.
- Generalized epilepsy in children often presents challenges in treatment.
- Refractory epilepsy requires evaluation of alternative therapeutic options.
Purpose of the Study:
- To assess the efficacy and tolerability of lacosamide in pediatric patients with refractory generalized epilepsy.
- To compare outcomes in children with Lennox-Gastaut Syndrome versus other generalized epilepsies.
Main Methods:
- Retrospective review of 21 pediatric patients with refractory generalized epilepsy treated with lacosamide (2009-2013).
- Patients were divided into two groups: Lennox-Gastaut Syndrome (Group I) and other generalized epilepsies (Group II).
- Efficacy was defined as seizure freedom or a ≥50% reduction in seizure frequency; tolerability was also assessed.
Main Results:
- Overall, 5 patients achieved seizure freedom, 9 had ≥50% seizure reduction, and 7 showed no response.
- In Group I (Lennox-Gastaut Syndrome), 7 patients had ≥50% improvement, and 1 showed no response.
- In Group II (other generalized epilepsies), 5 patients achieved seizure freedom, 2 had ≥50% improvement, and 5 showed no response.
Conclusions:
- Lacosamide demonstrates efficacy in managing refractory generalized epilepsy in children.
- The drug is well-tolerated in the pediatric population studied.
- Lacosamide appears particularly effective for children with Lennox-Gastaut Syndrome.
Abstract:
Lacosamide is FDA-approved in patients 17 years or older with partial-onset epilepsy. We evaluated the efficacy and tolerability of lacosamide in children with refractory generalized epilepsy. We retrospectively reviewed records of 21 children with refractory generalized epilepsy treated with lacosamide in our institution from 2009-2013 divided into 2 subgroups- I, Lennox-Gastaut Syndrome, and II, other generalized epilepsies. Efficacy was defined as seizure freedom or ≥50% seizure reduction. Descriptive data analysis including seizure freedom was compared using c(2) analysis. There were eleven females and ten males with a mean age, of 11.9 years. Five patients became seizure free, nine had ≥50% seizure reduction, and seven had no response. Group I: seven had ≥50% improvement, one did not respond. Group II: five became seizure free, two had ≥50% improvement, five had no response. Lacosamide is effective and well tolerated in children with refractory generalized epilepsy particularly patients with Lennox-Gastaut Syndrome.
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