Abstracts

Rationale: To conduct a prospective study regarding the efficacy of a novel anti-epileptic medication Vimpat (Lacosamide). Vimpat was approved by FDA in 2009 as an adjunctive treatment option for partial onset seizures in patients 17 years of age and older. It is an anti-epileptic medication (AEM) with novel mechanism of action and presumably few side effects. Methods: We are conducting a prospective review of 10 patients followed in our outpatient facility who were started on the new anti-epileptic drug Vimpat. All of the patients included in this study are adults with ages ranging from 20 to 61 years of age. The gender was exactly equally distributed between females and males. Of the 10 patients analyzed 50% suffered from complex partial seizures (CPS) with secondary generalization and 50% had CPS without generalization. Etiology of seizures was variable (including post encephalitis, post traumatic, vascular and heterotopias). Results: The longest follow up so far has been 1 year. The rest of the patients have been followed for about 6 to 10 months. Among all patients, 60% reported improvement in seizure frequency, 10% reported worsening of seizure frequency (therefore Vimpat was discontinued), 20% reported no change in seizure frequency, and 10% could not tolerate the medication. Most patients (60%) did not report any side effects, 20% had only mild side effects that subsided shortly after initiation of therapy, and these included dizziness and itching. However, 1 (10%) patients developed severe skin reaction(itching) and stopped the medication, and 1 (10%) patient reported severe generalized weakness and intolerable muscle stiffness. Conclusions: Epilepsy is a chronic neurological disorder affecting approximately three million people in the U.S. Only 47% will attain seizure control with their first AEM, and more than 30% will continue to experience seizures despite trying two or more AEMs. Vimpat (lacosamide) is a newly FDA approved antiepileptic medication for adjunctive treatment of partial onset seizures in people with epilepsy who are 17 years and older [American Epilepsy Society]. Vimpat s mechanism of action has been shown to involve the modulation of sodium channel activity in the nervous system. It is thought that Vimpat reduces sodium channel over-activity by prolonging the longer lasting resting state of the channel, a different action compared with current sodium channel blocking drugs. The most common adverse effects reported included diplopia, headache, dizziness and nausea. Our data indicated significant improvement in seizure frequency with the use of Vimpat. Although our study included limited number of patients, we can clearly establish improvement with the concomitant use of Vimpat and good tolerance of the medication. Further studies are necessary to be conducted with wider patient population to investigate the long term effect of Vimpat.