OBJECTIVE: Treatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin or valproate being the most common treatment. Once this first and second line treatment has failed SE is considered refractory (RSE). This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in RSE. METHOD: Patients with RSE who were treated with ivLCM in six Spanish centers were prospectively included. Efficacy was defined as cessation of seizures after starting ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following the standard protocol (benzodiazepines plus phenytoin or valproate) before ivLCM was added. RESULTS: Thirty-four patients were included, 52.9% men, with mean age of 60.15 years. In 58.9% of patients the etiology was symptomatic, and the most common type of SE was focal convulsive (82.4%). Mean initial bolus dose of LCM was 323.53mg. ivLCM was effective in more than half of patients (64.7%), with termination of SE before 12h in 50% of them. ivLCM was used as a fourth or later option in 76.5% of patients. No serious adverse events attributable to LCM were reported. CONCLUSIONS: LCM might be a fast, effective and safe add-on treatment in RSE.
OBJECTIVE: Treatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin or valproate being the most common treatment. Once this first and second line treatment has failed SE is considered refractory (RSE). This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in RSE. METHOD:Patients with RSE who were treated with ivLCM in six Spanish centers were prospectively included. Efficacy was defined as cessation of seizures after starting ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following the standard protocol (benzodiazepines plus phenytoin or valproate) before ivLCM was added. RESULTS: Thirty-four patients were included, 52.9% men, with mean age of 60.15 years. In 58.9% of patients the etiology was symptomatic, and the most common type of SE was focal convulsive (82.4%). Mean initial bolus dose of LCM was 323.53mg. ivLCM was effective in more than half of patients (64.7%), with termination of SE before 12h in 50% of them. ivLCM was used as a fourth or later option in 76.5% of patients. No serious adverse events attributable to LCM were reported. CONCLUSIONS:LCM might be a fast, effective and safe add-on treatment in RSE.
Authors: Aatif M Husain; Jong W Lee; Bradley J Kolls; Lawrence J Hirsch; Jonathan J Halford; Puneet K Gupta; Yafa Minazad; Jennifer M Jones; Suzette M LaRoche; Susan T Herman; Christa B Swisher; Saurabh R Sinha; Adriana Palade; Keith E Dombrowski; William B Gallentine; Cecil D Hahn; Elizabeth E Gerard; Manjushri Bhapkar; Yuliya Lokhnygina; M Brandon Westover Journal: Ann Neurol Date: 2018-06 Impact factor: 10.422
Authors: Estevo Santamarina; Manuel Toledo; Maria Sueiras; Miquel Raspall; Nadim Ailouti; Elena Lainez; Isabel Porta; R De Gracia; Manuel Quintana; Javier Alvarez-Sabín; Xavier Salas Puig Xavier Salas Puig Journal: J Neurol Date: 2013-12 Impact factor: 4.849
Authors: Sebastian Bauer; Laurent M Willems; Esther Paule; Christine Petschow; Johann Philipp Zöllner; Felix Rosenow; Adam Strzelczyk Journal: Ther Adv Neurol Disord Date: 2016-11-29 Impact factor: 6.570