Salvatore Grosso1, Nelia Zamponi2, Arnaldo Bartocci3, Elisabetta Cesaroni2, Silvia Cappanera2, Rosanna Di Bartolo4, Paolo Balestri4. 1. Pediatric Neurology-Immunology and Endocrinology Unit, University of Siena, Italy; Department of Pediatrics, University of Siena, Italy. Electronic address: grosso@unisi.it. 2. Child Neuropsychiatric Unit, University of Ancona, Italy. 3. Clinical Neurophysiology, University of Perugia, Italy. 4. Department of Pediatrics, University of Siena, Italy.
Abstract
OBJECTIVE: Status epilepticus (SE) is considered a life-threatening medical emergency. First-line treatment with antiepileptic drugs (AEDs) consists of intravenous benzodiazepines followed by phenytoin. SE is considered refractory (RSE) when unresponsive to standard doses of the first two AEDs. Scarce evidence is available to support specific guidelines for the management of RSE in either adults or children. This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in children affected by RSE. METHOD: Children with RSE who were treated with ivLCM were included in the study. Efficacy was defined as the cessation of seizures after administration of ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following standard protocols before ivLCM was administered. RESULTS: Eleven children entered the study (mean age: 9.4 years). Etiology was symptomatic in 7 patients (63%). RSE was convulsive (focal or generalized) in 6 patients and nonconvulsive in 5. The mean initial bolus dose of LCM was 8.6 mg/kg. The drug, which was used as a fourth or later option, was effective in stopping RSE in 45% of patients, with seizures terminating within 12 h in three children. No serious adverse events attributable to LCM were reported. CONCLUSIONS: LCM might be an effective and well-tolerated AED in children with RSE.
OBJECTIVE:Status epilepticus (SE) is considered a life-threatening medical emergency. First-line treatment with antiepileptic drugs (AEDs) consists of intravenous benzodiazepines followed by phenytoin. SE is considered refractory (RSE) when unresponsive to standard doses of the first two AEDs. Scarce evidence is available to support specific guidelines for the management of RSE in either adults or children. This study aimed to assess the efficacy and tolerability of intravenous (iv) lacosamide (LCM) in children affected by RSE. METHOD:Children with RSE who were treated with ivLCM were included in the study. Efficacy was defined as the cessation of seizures after administration of ivLCM, with no need for any further antiepileptic drug. All patients had been unsuccessfully treated following standard protocols before ivLCM was administered. RESULTS: Eleven children entered the study (mean age: 9.4 years). Etiology was symptomatic in 7 patients (63%). RSE was convulsive (focal or generalized) in 6 patients and nonconvulsive in 5. The mean initial bolus dose of LCM was 8.6 mg/kg. The drug, which was used as a fourth or later option, was effective in stopping RSE in 45% of patients, with seizures terminating within 12 h in three children. No serious adverse events attributable to LCM were reported. CONCLUSIONS:LCM might be an effective and well-tolerated AED in children with RSE.
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
Authors: David G Vossler; Jacquelyn L Bainbridge; Jane G Boggs; Edward J Novotny; Tobias Loddenkemper; Edward Faught; Marta Amengual-Gual; Sarah N Fischer; David S Gloss; Donald M Olson; Alan R Towne; Dean Naritoku; Timothy E Welty Journal: Epilepsy Curr Date: 2020-08-21 Impact factor: 7.500