TY - JOUR
T1 - Intravenous lacosamide in seizure emergencies
T2 - Observations from a hospitalized in-patient adult population
AU - d'Orsi, Giuseppe
AU - Pascarella, Maria Grazia
AU - Martino, Tommaso
AU - Carapelle, Elena
AU - Pacillo, Francesca
AU - Di Claudio, Maria Teresa
AU - Mancini, Daniela
AU - Trivisano, Marina
AU - Avolio, Carlo
AU - Specchio, Luigi M.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Purpose to evaluate the efficacy and safety of intravenous (IV) lacosamide (LCM) in the treatment of seizure clusters (SC) and status epilepticus (SE) in hospitalized adult patients. Methods we prospectively analyzed treatment response, seizure outcome, and adverse effects of IV LCM in 38 patients with seizure emergencies (15 with SC, 23 with SE) during a hospital stay. The loading dose of IV LCM was 200–400 mg and the maintenance dose was 200–400 mg daily. Response to IV LCM was evaluated within 20 min, 4 h and 24 h of LCM infusion. Results an acute anti-seizure effect after IV LCM was especially evident when it was first used – (SC) or second line (established SE) treatment. In particular, 87% of SC patients (13/15) and 80% of established SE (8/10) demonstrated response to LCM treatment, while no patients with super-refractory SE (0/8) responded to IV LCM according to our criteria. The loading of IV LCM was well tolerated, with mild adverse effects (2/38 temporary dizziness). In most patients, during and after administration of the loading dose of IV LCM a temporary (30 min–1 h) sedation was observed. No ECG and laboratory values-changes were documented in any of the patients. Conclusions LCM is an effective and well-tolerated treatment when used to treat SC in hospitalized adult patients. As add-on therapy, it may be useful to stop seizure activity in patients with focal SE not responding to first/second-line intravenous AEDs.
AB - Purpose to evaluate the efficacy and safety of intravenous (IV) lacosamide (LCM) in the treatment of seizure clusters (SC) and status epilepticus (SE) in hospitalized adult patients. Methods we prospectively analyzed treatment response, seizure outcome, and adverse effects of IV LCM in 38 patients with seizure emergencies (15 with SC, 23 with SE) during a hospital stay. The loading dose of IV LCM was 200–400 mg and the maintenance dose was 200–400 mg daily. Response to IV LCM was evaluated within 20 min, 4 h and 24 h of LCM infusion. Results an acute anti-seizure effect after IV LCM was especially evident when it was first used – (SC) or second line (established SE) treatment. In particular, 87% of SC patients (13/15) and 80% of established SE (8/10) demonstrated response to LCM treatment, while no patients with super-refractory SE (0/8) responded to IV LCM according to our criteria. The loading of IV LCM was well tolerated, with mild adverse effects (2/38 temporary dizziness). In most patients, during and after administration of the loading dose of IV LCM a temporary (30 min–1 h) sedation was observed. No ECG and laboratory values-changes were documented in any of the patients. Conclusions LCM is an effective and well-tolerated treatment when used to treat SC in hospitalized adult patients. As add-on therapy, it may be useful to stop seizure activity in patients with focal SE not responding to first/second-line intravenous AEDs.
KW - Hospitalized adult population
KW - Lacosamide
KW - Seizure clusters
KW - Seizure emergencies
KW - Status epilepticus
KW - Video-EEG monitoring
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U2 - 10.1016/j.seizure.2016.09.004
DO - 10.1016/j.seizure.2016.09.004
M3 - Article
AN - SCOPUS:84988959229
VL - 42
SP - 20
EP - 28
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
SN - 1059-1311
ER -