Refractory Ventricular Tachycardia and Seizures With Lacosamide Overdose
Chris Marcellino1,2,3, Chase C Ransom4, Eelco F Wijdicks1
1Department of Neurology, Mayo Clinic, Rochester, USA.
Cureus
|October 31, 2022
Summary
An intentional overdose of lacosamide led to status epilepticus and dangerous heart arrhythmias. This case highlights the severe risks associated with high doses of lacosamide, requiring extensive medical intervention.
Area of Science:
- Clinical Toxicology
- Neuropharmacology
- Cardiology
Background:
- Lacosamide is an antiepileptic drug used to treat partial-onset seizures.
- Intentional overdoses of lacosamide are rare but can lead to severe toxicity.
- Understanding the full spectrum of lacosamide toxicity is crucial for patient management.
Observation:
- A 60-year-old female presented with status epilepticus following an intentional lacosamide overdose.
- The patient developed refractory ventricular arrhythmia, requiring advanced cardiac life support.
- Management included consideration of extracorporeal membrane oxygenation and percutaneous stellate ganglion blockade.
Findings:
- Status epilepticus was a direct consequence of lacosamide toxicity.
- Refractory ventricular arrhythmia complicated the clinical course, necessitating intensive interventions.
- The patient experienced an embolic stroke in the left middle cerebral artery.
Implications:
- High-dose lacosamide presents significant risks, including neurological and cardiovascular emergencies.
- This case underscores the importance of careful dosing and monitoring of lacosamide.
- Advanced life support strategies may be required in severe lacosamide toxicity cases.
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