ObjectiveTo observe the clinical effect of Lacosamide (LCM) in the treatment of children with intractable epilepsy.Methods41 cases of refractory epilepsy patients who received LCM from March to July 2019 in department of Neurology, General Hospital of Henan Province were collected which included 21 males, 20 females, age were 4.6 ~ 15.5 years, average (7.21±3.06) years, And the efficacy of LCM was observed through blank control study.ResultsAfter LCM was added to the blank self-control group, the frequency of epileptic seizures was significantly reduced during the follow-up period of 3 months and 6 months, with statistically significant difference (P<0.05), and the mental state of the children was effectively improved, but there was no statistical significance between focal refractory epileptic seizure and comprehensive refractory epileptic seizure (P>0.05).ConclusionsLCM is a new kind of the third generation of antiepileptic drug. The addition use of LCM can effectively reduce the seizure frequency and improve mental state in children with refractory epilepsy.
ObjectiveTo observe and analyze the efficacy and adverse reactions of Lacosamide (LCM) in the treatment of refractory epilepsy in children and adolescents. MethodsA retrospective cohort study was conducted on 85 patients with refractory epilepsy, with 50 males and 35 females, aged 0.5 ~ 15 years with an average age of (6.90±3.61) years, who were treated in the Department of Neurology of Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, from January 2020 to March 2023. A self-controlled study was conducted by oral LCM add on treatment, and follow-up was performed to compare and observe the efficacy as well as the adverse reactions before and after the use of LCM. ResultsBy self-control, after 12 months of follow-up after addition of LCM treatment, compared with baseline, the frequency of seizures decreased after 3, 6 and 12 months of treatment, the differences were statistically significant (P<0.05), and the effective rate of analysis after 3, 6 and 12 months of addition of treatment were 36.47%, 42.35% and 41.18%, respectively. There were 22 cases without seizure after 12 months of LCM treatment, and the seizure-free rate was 25.88%. Enrolled patients used a variety of antiseizure medications at baseline, and the three drugs used by the most patients were sodium valproate in 54 cases (63.53%), levetiracetam in 41 cases (48.24%) and oxcarbazepine in 24 cases (28.24%) respectively. After addition of LCM, a total of 10 cases experienced adverse reactions, such as dizziness, headache, nausea, etc. The incidence of adverse reactions was 11.76%. The retention rate at 12 months after adding LCM was 63.5%. ConclusionsThe addition of LCM in the treatment of refractory epilepsy in children and adolescents can effectively improve the frequency of seizures, with fewer adverse reactions and higher retention rates.
ObjectiveTo observe the efficacy and safety of lacosamide (LCM) as a monotherapy or as an add-on in the treatment of focal epilepsy in children aged 4 months to 4 years. MethodsThe study included 20 children with focal epilepsy who received oral LCM monotherapy or add-on therapy in Children's Hospital Affiliated to Soochow University from March 2022 to September 2022, including 9 males and 11 females with an average age of (22.4±13.0) months. The curative effects and adverse reactions at 1, 2, 3, 4, and 6 months after LCM treatment were analyzed. The initial dose of LCM was 2 mg/(kg·d) and increased by 2 mg/(kg·d) every week, maintenance dose 6 ~ 12mg/(kg·d). Results During the follow-up period of this study, the total effective cases were 17 (85.00%), and the number of control-free cases was 15 (75.00%). Conclusion LCM can effectively reduce the frequency of epileptic seizures in the monotherapy or add-on treatment of infants and young children with focal epilepsy, with few adverse reactions and high retention rate, which has high clinical application value.
Epilepsy (EP) is one of the most common chronic nervous system disease in childhood and adolescence, with a prevalence rate of 7.6‰. About 3/4 of epilepsy patients begin to get sick in childhood. At present, there are many ways to treat epilepsy, such as oral anti-seizure medications (ASMs), surgical treatment, ketogenic diet, etc. However, ASMs are the preferred treatment for most epilepsy patients and the most important and basic treatment. Oxcarbazepine (OXC) and Lacosamide (LCM) are both sodium channel blockers. The former is a second-generation ASMs, a fast sodium channel blocker, while the latter is a third-generation ASMs, a slow sodium channel blocker. The rapid inactivation of sodium channel is mediated by the inner pore ball chain mechanism in milliseconds, which is helpful to the termination of action potential and the regulation of refractory period. It is the main inactivation mode under normal physiological conditions. Different from the rapid inactivation of sodium channels, the slow inactivation is in seconds per minute, which may involve the rearrangement of the inner pore structure and increase the excitability of the action potential threshold regulating membrane. Generally, under pathological conditions, sodium channels are more likely to enter the slow inactivation state. Now, OXC and LCM have been approved by the US Food and Drug Administration, the European Union Drug Administration, and the National Drug Administration of China for monotherapy or additive therapy of focal origin (with or without secondary generalized seizures) in epilepsy patients aged 4 years and above. This article will focus on the pharmacokinetics, efficacy, and safety of LCM and OXC in the treatment of childhood epilepsy.