Abstracts

Rationale: The aim of the study is to evaluate the safety and efficacy of intravenous Lacosamide in children with intractable epilepsy. The medication offers a novel mechanism of action and new potential for pediatric use. There have been no previously reported case series describing the use of intravenous Lacosamide in the pediatric population. Methods: After approval from the Institutional Review Board of the University of Chicago, the records of patients with epilepsy treated with Lacosamide from January 2009 to October 2009 were reviewed. Patients less then 16 years old with intractable complex partial epilepsy were included. Age, sex, type of seizures, medication, previous surgery, duration of treatment efficacy and side effects were assessed. No institutional, public, or industry funding was used to develop this study. Results: 9 patients (5 males and 4 females) met the inclusion criteria for the study. All patients tolerated Lacosamide infusion well. The most common side effect was drowsiness during the initial titration phase. In one patient, serum Valproate levels fluctuated during first 3 days of therapy before stabilizing. Another patient reported exacerbation of insomnia (which had already been a problem prior to Lacosamide therapy). Six patients had reduction in seizure frequency at more than 4 weeks of maintenance therapy. Three patients showed no reduction in seizure frequency; however in one of those we were able to reduce her concomitant Phenytoin dose without any increase in seizure frequency. This patient had a history of requiring high levels of Phenytoin to maintain a mild degree of seizure control. Interestingly, of the three patients who showed no response to Lacosamide, two of them had both complex partial and generalized epilepsy. Conclusions: To our knowledge this is the first paper in the literature that describes usage of intravenous Lacosamide in children. Our findings suggest Lacosamide may be an effective anticonvulsant medication and highly tolerable even with rapidly escalating doses when given parentally in pediatric patients with refractory epilepsy.