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Intravenous Lacosamide Therapy for Pediatric Patients With Cluster Seizures
Ryuki Matsuura1, Shin-Ichiro Hamano2, Kenjiro Kikuchi1
1Division of Neurology, Saitama Children's Medical Center, Chuo-ku, Saitama, Japan; Department of Pediatrics, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Insights
Intravenous lacosamide effectively treated cluster seizures in pediatric patients, with 48% achieving seizure freedom. This epilepsy treatment showed no adverse events, indicating its potential as a safe therapeutic option.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Pharmacology
Background:
- Limited research exists on intravenous lacosamide for pediatric cluster seizures.
- Investigating efficacy and safety is crucial for this patient population.
Purpose of the Study:
- To evaluate the effectiveness and safety of intravenous lacosamide in treating pediatric cluster seizures.
- To determine response rates and identify factors influencing treatment outcomes.
Main Methods:
- Retrospective study of 25 pediatric patients with cluster seizures treated with intravenous lacosamide.
- Defined cluster seizures and response criteria (seizure freedom for ≥12 hours).
- Analyzed seizure frequency, etiology, age at onset, and lacosamide dosage.
Main Results:
- 48% (12/25) of patients responded to intravenous lacosamide therapy.
- 52.9% of patients receiving it as first-line therapy achieved complete seizure remission.
- No adverse events were reported during the study period.
Conclusions:
- Intravenous lacosamide is a promising treatment for pediatric cluster seizures.
- The therapy demonstrated a favorable safety profile in this cohort.
- Further research may confirm its role in managing pediatric epilepsy.
Background:
Few studies have investigated intravenous lacosamide use to treat cluster seizures in pediatric patients. Therefore, we aimed to investigate the efficacy and safety of intravenous lacosamide therapy in pediatric patients with cluster seizures.
Methods:
We retrospectively evaluated the efficacy and safety of intravenous lacosamide therapy in 25 pediatric patients with cluster seizures at Saitama Children's Medical Center between March 2019 and June 2023. Cluster seizures were defined as a single seizure of less than five minutes duration, repeated three or more times within 12 hours, with recovery of consciousness between seizures. Response was defined as seizure freedom for at least 12 hours after lacosamide infusion.
Results:
The median age at onset of epilepsy was 1.5 (0.0 to 9.8) years. The median seizure frequency was 5 (3 to 20) times per 12 hours. The etiologies were remote (n = 17), acute (n = 4), and progressive (n = 4). The median age at which intravenous lacosamide therapy was administered was 4.2 (0.0 to 11.3) years. The median lacosamide dose was 2.6 (1.3 to 5.2) mg/kg. In total, 12 of 25 patients (48.0%) responded. Among patients treated with intravenous lacosamide as first-line therapy, nine of 17 (52.9%) had complete seizure remission. The frequency of complete seizure remission in patients with remote etiologies was 58.8% (10 of 17); among them, seven of 12 (58.3%) patients with structural abnormalities showed complete seizure remission. No adverse events were observed.
Conclusions:
Intravenous lacosamide therapy is a potentially useful treatment option for cluster seizures in pediatric patients.
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