Subcutaneous lacosamide for continuous focal seizures.

Area of Science:

• Palliative Medicine
• Neurology
• Pharmacology

Background:

• Managing continuous focal seizure activity in conscious palliative care patients presents a challenge, requiring a balance between seizure control and medication-induced sedation.
• Existing anti-seizure medications (ASMs) can cause significant sedation, impacting patient quality of life.
• Alternative administration routes are needed when enteral intake is not feasible.

Purpose of the Study:

• To present a case report on the use of subcutaneous lacosamide in a palliative care patient with continuous focal seizure activity.
• To evaluate the efficacy and tolerability of subcutaneous lacosamide as part of a multi-modal treatment regimen.
• To contribute to the limited literature on subcutaneous lacosamide administration.

Main Methods:

• A case report detailing the administration of subcutaneous lacosamide.
• Integration of subcutaneous lacosamide into a multi-modal treatment plan for continuous focal seizures.
• Monitoring of seizure control and adverse effects, particularly sedation.

Main Results:

• Subcutaneous lacosamide was successfully administered as part of a multi-modal approach for continuous focal seizure activity.
• Lacosamide demonstrated a favorable side effect profile, with minimal sedation observed.
• The study contributes to the limited data on subcutaneous lacosamide administration.

Conclusions:

• Subcutaneous lacosamide is a potentially valuable option for individualized care in palliative patients with continuous focal seizures, offering a non-sedating alternative.
• Lacosamide's physicochemical properties make it suitable for subcutaneous administration.
• Further research is warranted to explore its role in managing neuropathic pain when enteral routes are unavailable.