Abstracts

Rationale: The aim of the current study was to evaluate efficacy and safety of Eslicarbazepine Acetate (ESL) as add on therapy in epilepsy with focal onset seizures in adult patients and, at the same time, ESL effect on EEG background activity. Methods: This retrospective study was conducted in two universitary Epilepsy Centers (Policlinico Umberto I, Sapienza University  and Campus Biomedico of Rome). We evaluated 50 patients suffering from epilepsy with focal-onset seizures (mean age 48 ± 14 ys, 23 males, 46%), with an epilepsy history of 17±13 years: they had tried medication with a mean of 3±1 AEDs before introducing ESL.ESL  was introduced at an initial dose of 400 mg/die and it was increased until up 1200 mg/die.Seizure’s frequency and possible side effects was evaluated by an epilepsy diary completed by patients.  Quantitative EEG analysis was conducted considering the absolute and  relative power of the main frequency bands (delta, theta, alfa, beta) in the whole scalp or differentiated into the two hemispheres (affected and not affected). Individual alfa frequency (IAF) was also performed.  Clinical and EEG evaluation was conducted at three time points: basal (T0), three (T1) and six months (T2) after the introduction of ESL. Results: Before ESL introduction (T0), our patients presented 10 ±  21 seizures/month. At the end of follow-up ESL reduced significatively seizures (Wilcoxon test, p = 0,0001). 60% of patients reported a reduction of seizures ≥50% and, of them,  31% were seizure free. An additional 11% of the study population presented a reduction of seizures ≤50%, while the last 29% didn’t refer any change in seizure frequency.EEG quantitative analysis, didn’t show any significant modification on absolute or relative power of single frequency bands. Individual alfa frequency (IAF) did not demonstrate any modification. Conclusions: ESL confirmed its efficacy in reducing seizures as an add-on therapy in patients suffering from epilepsy with focal-onset seizures. In our sample, the lack of modification on IAF underlines that background EEG activity didn’t change after ESL exposition: in particular, IAF didn’t slow down, even after the introduction of a further AED, and it could reflect a good tolerability without significant cognitive impact of ESL and, definitely, a good efficacy profile. This result is also supported by the lack of increase of EEG delta and theta power, known to be related to sleepiness and cognitive impairment.In conclusion, in our sample of patients, ESL confirmed its efficacy and tolerability through clinical and EEG objective parameters such as seizure’s number and quantitative EEG analysis.  The good cognitive tolerability is a key factor for the choice of an add-on therapy in epileptic patients with drugresistant seizures. Our data suggest ESL as a valid choice for focal epilepsie in terms of efficacy and tolerability. Funding: This study received a EISAI grant.