Abstracts

Rationale: Lacosamide (LCM) is an antiepileptic drug approved as an adjunctive treatment for focal epilepsies. It enhaces slow inactivation of sodium channel blockers. Patients with vascular risk factors and/or stroke are usually aged and polimedicated. LCM could represent a good therapeutic option in these patients. Our aim is to analyze efficacy and tolerability of LCM as coadyuvant treatment in focal epilepsies of vascular origin Methods: Observational, retrospective, multicentric study in 6 Neurology Departments in Spain. Patients older than 18 years old suffering from partial seizures of vascular origin (prior stroke and/or presence of vascular risk factors) and starting LCM treatment were followed for a 12 month period. Vascular risk factors, past medical history of ischaemic stroke or cerebral haemorrage, type and frequency of previous seizures and efficacy and tolerability were analyzed. At least 1 seizure has occurred in the previous 3 months Results: Analisys of clinical data at 3 months was performed. Forty-two patients were included with a 76% of males. Median age was 69 [56, 77] years old. Mean time of evolution of the epilepsy was 4 years (SD 4.4). Median seizure frequency in the 3 months prior to LCM was 5.7 [2, 10.6] with a clear predominance of complex partial seizures (57%) followed by simplex partial seizures (23.81%). 54.8% suffered from at least one cardiovascular risk factor (high blood preassure, Diabetes Mellitus, dislipaemia or smoking). Medium dosage of LCM was 232.9 (SD 86.5) mg/day. LCM was added to sodium channel blockers (17%), non-sodium channel blockers (59%) or both (24%). After introduction of LCM, 89% of patients were responders and 57% were seizure free. 25% (n=8) of patients notified adverse events. In one patient a suicidal attempt was noticed with no harm or sequelae Conclusions: Our results after 3 months of follow up show a high efficacy and a good tolerability thus occurrence of serious adverse events can still occur. High percentage of responders and seizure-free patients may be in relation with the etiology of epilepsy. Medium dosages of LCM employed help to explain the low incidence of adverse effects. Further follow-up is needed to assure these results