Abstract Ref Number = APCP1130
EFFECTIVENESS AND ADVERSE EFFECT OF INTRAVENOUS LACOSAMIDE IN NONCONVULSIVE STATUS EPILEPTICUS AND ACUTE REPETITIVE SEIZURES IN CHILDREN
MONSICHA NGAMPOOPUN,Piradee Suwanpakdee,Charcrin Nabangchang,Nuttapon jaisupa
Phramongkutklao hospital Neurology Division, Department of Pediatrics, Phramongkutklao hospital Department of Pharmacology, Phramongkutklao College of Medicine
Background : Nonconvulsive status epilepticus (NCSE) and acute repetitive seizures (ARS) are associated with significant comorbidity and mortality. Due to the lack of randomized-controlled trials of intravenous antiepileptic drugs (AEDs) in these conditions, trials of a new generation of AEDs in this aspect are needed.
Material : A prospective interventional study was conducted in children under 18 years of age with NCSE or ARS who either had contraindication to, or were refractory to first-line AEDs, and received intravenous lacosamide. Demographic data, the efficacy of treatment, and adverse effects were recorded.
Results : Eleven patients with a median age of 11 years, predominantly female (72.7%), were enrolled. Average loading dose was 227 mg (8.3 mg/kg/dose) and average daily maintenance dose was 249 mg (4.6 mg/kg/dose). All patients (100%) experienced a reduction in seizure frequency within 24 hours. Eight of eleven patients (72.7%) experienced a reduction in seizure frequency of more than 50% by the end of the study, and one patient became seizure-free. In terms of adverse events, one patient had a bradycardia without prolongation of the PR interval. Interestingly, there was a case of neuronal ceroid lipofusinosis in which a significant improvement in seizure control was achieved.
Conclusions : The results indicate that intravenous lacosamide may be an alternative treatment for NCSE or ARS in children. To our knowledge, this is the first study on the use of intravenous lacosamide in Asian children.
Keywords: Intravenous lacosamide status epilepticus acute repetitive seizures