Rapid loading of intravenous lacosamide: Efficacy and practicability during presurgical video‐EEG monitoring. Issue 1 (21st September 2012)

• Record Type: Journal Article
• Authors: Li, Wenjie; Stefan, Hermann; Matzen, Julia; Rampp, Stefan; Heinze, Hans‐Joachim; Schmitt, Friedhelm C.
• Is Part Of: Epilepsia. Volume 54:Issue 1(2013:Jan.)
• Page Start: 75
• Page End: 80
• Publication Date: 2012-09-21
• Subjects: Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/j.1528-1167.2012.03651.x
• Languages: English
• ISSNs: 0013-9580

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Summary</title> <p> <bold>Purpose: </bold> This study investigates immediate efficacy and safety of intravenous application of de novo lacosamide (LCM) as add‐on therapy in patients with pharmacoresistant focal epilepsy.</p> <p> <bold>Methods: </bold> During presurgical video–electroencephalography (EEG) monitoring, 17 adult inpatients received LCM infusion (200 mg every 12 h for 2–3 days) followed by oral formulation with the same regimen. Before and after intravenous application of LCM, seizures and interictal epileptiform discharges (IEDs) recorded with continuous video‐EEG monitoring were analyzed, and an assessment of adverse events (AEs) was performed daily. To evaluate the midterm tolerability and efficacy, follow‐up visits were conducted 1 and 3 months after discharge from hospital.</p> <p> <bold>Key Findings: </bold> In the acute phase, intravenous initiation of LCM was well tolerated with few mild or moderate AEs (3 of 17, 17.6%). A significant reduction of seizure frequency in the treatment phase as compared to mean seizure frequency in the 2‐day baseline phase was achieved (p < 0.05 for the first treatment day, and p < 0.005 for the second treatment day). On the first treatment day, 61.5% of the patients were seizure free, and 84.6% on the second treatment day. IED reduction after intravenous application of LCM was not significant. After 1 month, the 50% responder rate was 46.6% and after the 3‐month period, 42.8%.</p> <p> <bold>Significance: </bold> Our data suggest that rapid intravenous initiation of de novo LCM is safe and may protect against seizures in a rapid and midterm time window.</p> </abstract>