Intravenous lacosamide as treatment option in post-stroke non convulsive status epilepticus in the elderly: A proof-of-concept, observational study

Vincenzo Belcastro, Simone Vidale, Laura Pierguidi, Luigi Sironi, Lucia Tancredi, Pasquale Striano, Angelo Taborelli, Marco Arnaboldi

Research output: Contribution to journalArticle

Abstract

Purpose To evaluate the efficacy and safety of intravenously administered lacosamide (iv LCM) in post-stroke non convulsive status epilepticus (NCSE) in elderly patients. Methods We enrolled 16 patients (7 M/9 F; 77 ± 7 years of age) with NCSE. iv LCM was used in all the patients as initial treatment (i.e. patients were directly started on LCM) at a loading dose of 400 mg over 30 min, followed by a mean maintenance dose of 400 mg per day. iv LCM was considered as effective in patients who experience no NCSE for 24 h following treatment, as evaluated by EEG recording and clinical observation. Results LCM was effective in treating NCSE in eight of the sixteen patients in whom epileptic activity disappeared (7/8) or was significantly reduced (1/8) within 45-60 min after administration. None of these patients relapsed in the following 24 h. No adverse events were observed. A partial anterior circulation syndrome (PACS) was present in 10 patients while a total anterior circulation syndrome (TACS) in six. Conclusions This pilot study suggests that LCM exhibits safety and efficacy profiles which make it an optimal candidate as a first-choice drug against post-stroke NCSE in elderly patients. A prospective comparative trial is needed to confirm these preliminary data.

Original languageEnglish
Pages (from-to)905-907
Number of pages3
JournalSeizure
Volume22
Issue number10
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Antiepileptic drugs
  • Benzodiazepines
  • Lacosamide
  • Non convulsive status epilepticus
  • Post-stroke seizures

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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