Abstracts

Rationale: Lacosamide(LCM) has an intravenous formulation with favorable side effect profile and a low potential for drug interaction; furthermore it exhibits linear pharmacokinetics. For these reasons, it is a possibility for use in SE. Our aim is describe the efficacy of LCM in SE in both situations of refractory and non-refractory status Methods: We analyzed all SE in which intravenous LCM was used from September-2010 to June-2012. Demographic variables, status etiology, AEDs used, loading dose, infusion rate, treatment response and time of resolution were collected. We initially analyzed patients in which LCM was used as a 4/5th option(refractory); subsequently we analyzed all patients where LCM was used as 2nd/3rd option (non-refractory). Results: We evaluated a total of 31 patients: 19 were refractory to other AEDs. 63% of them responded to LCM. Median dose was 400mg (200-600). When comparing responders and non-responders, those patients with convulsive or minor motor symptoms (p=0.05), or without previous epilepy (p=0.024) had a worse response. We found no differences in either the dose or infusion rate. In a second group of 12 patients, LCM was used earlier (2/3 option). In this case the efficiency was 70%. Regarding the etiology, all non-responders were acute symptomatic. Median dose was 400mg (200-600), and the infusion rate of 40 mg / min. There were no major side effects. Conclusions: Despite its limitations, LCM is an alternative and useful therapeutic tool for treatment of SE, mainly in patients with previous epilepsy and non-convulsive status. The effectiveness seems to increase slightly when it is administered earlier.