Abstracts

Rationale: Many children with intractable epilepsy require rational polytherapy. ideal drugs offer broad spectrum and minimal side effects. Lacosamide represents a novel mechanism based on slow sodium channel modulation. This may offer safe add-on therapy for patients with intractable seizures in pediatric age group.Patients with intractable seizures under 17 years of age were offered lacosamide as add-on therapy. this represented an off label use based on current labeling for use in ages 17 and above. Rational polytherapy wiht novel mechanism may offer advantages over prior monotherapy, or older antiepileptic agents. Methods: All patients under 17 years of age offered lacosamide add-on therapy between June 2009 and September 2009 had charts reviewed for efficacy, and side effects from lacosamide. Data for number of other drugs used with add-on, age, and duration of therapy were reviewed. Results: Twenty-three patients received lacosamide under the age of 17 years. Average age was 7.25 years ( range 1.75-16). Dosage averaged 100mg/day ( average 3.6mg/kg) and seizure efficacy showed > 50% reduction in 10/23 patients(43%with1patient complete control, 2 patients > 80% improved). Adverse effect was dizziness, or fatigue in 2 patients only. Idiopathic partial seizures improved greater than patients with generalized epilepsy, or congenital brain malformations; two cases CSWS had no response. Conclusions: Lacosamide is safe and well tolerated in patients with intractable epilepsy. Those with partial seizures of idiopathic non-lesional type had greatest response. No help was seen in 2 cases of CSWS. More controlled observation of lacosamide in pediatric epilepsy as add-on therapy is warranted.