Lacosamide monotherapy for the treatment of childhood epilepsy with centrotemporal spikes.

Abstract

OBJECTIVE:

Childhood epilepsy with centrotemporal spikes (CECTS) is known as age-limited focal epilepsy syndrome in childhood. Lacosamide is a third-generation antiepileptic drug. This study aimed to evaluate the efficacy of lacosamide monotherapy for the treatment of CECTS.

METHODS:

We enrolled 18 patients (6 girls and 12 boys) who met the following criteria: 1) the age of onset of the seizures was between 3 and 13 years of age; 2) showing at least hemifacial and/or oropharyngeal seizures; 3) interictal discharges in central and/or middle temporal electrodes; 4) no intellectual disability; 5) treatment duration of lacosamide monotherapy over 6 months. We retrospectively collected and analyzed clinical data and treatment information. We evaluated the seizure occurrences during 0-3, 4-6, and 7-12 months from the treatment initiation and the last 6 months of the follow-up. We also evaluated the outcomes as seizure-free if the patients developed no seizures both over 6 months and 3 times of pretreatment mean seizure interval at the last follow-up.

RESULTS:

Of the patients, 39%, 67% and 72% were seizure-free during 0-3, 4-6, and 7-12 months from treatment initiation, respectively. Finally, 83% of the patients achieved seizure freedom. Seizure freedom was achieved in 72% during the first 4 months of treatment. All patients continued lacosamide monotherapy during the study, although four patients showed transient fatigue or somnolence.

CONCLUSIONS:

Lacosamide showed good efficacy for controlling seizures with fewer adverse effects, and therefore may be a good candidate as a first-line medication for the treatment of new-onset CECTS.

• Authors: Tohru Okanishi, Yuji Fujii, Satoru Sakuma, Hideaki Shiraishi, Hirotaka Motoi, Kotaro Yazaki, Hideo Enoki, Ayataka Fujimoto
• Journal: Brain & development (Brain Dev) Vol. 44 Issue 6 Pg. 380-385 (Jun 2022) ISSN: 1872-7131 [Electronic] Netherlands
• PMID: 35241306 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Chemical References

• Anticonvulsants
• Lacosamide

Topics

• Anticonvulsants
• Epilepsies, Partial (drug therapy)
• Female
• Humans
• Infant
• Lacosamide (therapeutic use)
• Male
• Retrospective Studies
• Seizures (drug therapy)
• Treatment Outcome