Sodium channel blockers are effective for benign infantile epilepsy
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Published on: May 16, 2019
Shingo Numoto1, Hirokazu Kurahashi1, Mizuki Takagi1
1Aichi Medical University, Department of Pediatrics, Nagakute, Japan.
Insights
Low-dose lacosamide (LCM) effectively controlled seizures in children with benign infantile epilepsy (BIE) without adverse effects. Levetiracetam (LEV) was less effective, with seizure recurrence observed in treated patients.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Benign infantile epilepsy (BIE) is a rare epilepsy syndrome.
- Identifying effective antiseizure medications (ASMs) for BIE is crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy and tolerance of lacosamide (LCM) and levetiracetam (LEV) in pediatric patients diagnosed with BIE.
- To investigate the role of PRRT2 gene mutations in BIE.
Main Methods:
- Retrospective analysis of clinical data from 24 children with BIE (2014-2020).
- Assessment of treatment outcomes, effectiveness, and adverse effects of ASMs.
- PRRT2 gene analysis using Sanger sequencing in a subset of patients.
Main Results:
- Fourteen out of 24 children received ASM treatment; 4 patients had identified PRRT2 mutations.
- All five children treated with low-dose LCM (2 mg/kg/day) achieved seizure freedom, comparable to carbamazepine.
- No adverse effects were reported with LCM treatment.
- Two patients treated with LEV experienced seizure recurrence; one patient became seizure-free after switching to carbamazepine.
Conclusions:
- Low-dose lacosamide demonstrates high efficacy and excellent tolerance in managing benign infantile epilepsy.
- Levetiracetam showed insufficient efficacy in this cohort of BIE patients.
- PRRT2 gene mutations may be associated with BIE, warranting further investigation.
Objective:
To examine the efficacy and tolerance of the antiseizure medications lacosamide (LCM) and levetiracetam (LEV) in patients with benign infantile epilepsy (BIE).
Methods:
The clinical data of 24 children with BIE seen between 2014 and 2020 were collected retrospectively, and treatment, effectiveness, and adverse effects were examined. PRRT2 gene analysis was performed using Sanger sequencing.
Results:
Of the 24 children with BIE, 14 were treated with antiseizure medications. PRRT2 gene analysis was performed in 14 children, and mutations were identified in 4, including a pair of siblings. All five children treated with LCM became seizure-free, similar to those treated with carbamazepine. The LCM does was 2 mg/kg/day in all cases. There were no adverse effects in any patient treated with LCM. By contrast, both patients treated with LEV had seizure recurrence. In one patient, LEV was replaced with CBZ, resulting in seizure freedom.
Conclusions:
Low-dose LCM was effective and well tolerated in patients with BIE, whereas LEV was insufficiently effective.
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