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Lamotrigine in resistant childhood epilepsy
Neuropediatrics
|December 1, 1993
Summary
Lacosamide (LTG) showed promise as an add-on therapy for refractory epilepsy in children, significantly reducing seizure frequency in most participants. Optimal therapeutic effects were observed at specific plasma concentrations of lacosamide.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Refractory epilepsy in children presents significant treatment challenges.
- Add-on antiepileptic drug (AED) therapy is often necessary for managing difficult-to-treat cases.
Purpose of the Study:
- To evaluate the efficacy and tolerability of lacosamide (LTG) as adjunctive therapy in pediatric patients with refractory epilepsy.
- To determine optimal plasma concentrations for lacosamide treatment in this population.
Main Methods:
- A cohort of 14 children with refractory epilepsy received lacosamide (LTG) as add-on therapy.
- Dosages were adjusted based on concomitant AEDs, with titration up to 2 mg/kg/day (with VPA) or 10 mg/kg/day (with hepatic-metabolized AEDs).
- Seizure frequency, side effects, and plasma LTG concentrations were monitored.
Main Results:
- Six out of seven patients completing the study showed a decrease in seizure frequency after one year.
- Median total seizure frequency decreased from 10.7 to 3.8 seizures per day.
- Significant seizure reduction (>50% to seizure-free) was achieved in 4 patients; optimal results correlated with plasma LTG levels of 0.5–5.4 µg/mL.
Conclusions:
- Lacosamide (LTG) is a potentially effective add-on treatment for pediatric refractory epilepsy.
- Careful monitoring of plasma concentrations is recommended to achieve optimal therapeutic outcomes and minimize adverse events.
- Further research is warranted to confirm these findings in larger pediatric cohorts.