Abstracts

Rationale: Neuroncologic patients often have epileptic seizures. The pharmacological characteristics of Lacosamide are attractive to avoid complications in such patients.Methods: Multicentric retrospective study of patients with tumor related epilepsy who have been treated with Lacosamide. Data regarding efficacy, side effects and concomitant medications in acute seizures or chronic epilepsy were analyzed.Results: We recruited 48 patients with 7 months median follow-up. Age 54.6 (±14) and 66% males. Primary brain tumors were 56.3%, systemic neoplasms 37.5% and paraneoplastic encephalitis 6.3%. Malignancies were 67%. Survival rate after two years was 32%. Nearly 75% showed baseline side effects. Low-grade tumors were more likely to have therapeutic failure, although they showed a decreased seizure frequency. However, high-grade tumors showed a significant seizure reduction after starting Lacosamide. Refractory status epilepticus (71%) at the onset of the disease was the main condition to use IV Lacosamide. Of them 73% were resolved with a median time of 10 hours, in the presence of somnolence (41%) as the main adverse event. Overall efficacy of Lacosamide was 72% of significant seizure reduction, 37.5% improved the baseline side effects, 54% reduced doses or stopped other antiepileptic drugs and 42% was able to decrease the doses of corticoids.Conclusions: Lacosamide can contribute to optimize the oncologic treatment by improving seizure control or avoiding side effects of other therapies. Lacosamide seems to be a good option to treat Status Epilepticus in neuroncologic patients.