Abstracts

Rationale: Lacosamide (LCM) has been approved as adjuntive treatment in the treatment of Partial Epilepsy. There have also been reports about the use of this new drug in the management of status epilepticus. We performed a systematic review to assess the use of LCM in status epilepticus. Methods: We included all clinical reports of patients with status epilepticus (convulsive and non-convulsive), in who LCM was used alone or in combination with other agents. We interrogated MEDLINE and LILACS, and found 137 abstracts. Of them we selected 16. We excluded review articles, letters to editor (without clinical cases), editorials, and duplicate studies. We also included 8 abstracts from epilepsy meetings. 16 were case series. Results: Of these 24 papers, there were 222 patients (Age: 56.8 years), and 56 had convulsive status. 208 had refractory status epilepticus. The LCM dose ranged from 50 to 400 mf (median dose: 200mg) as an initial dose, followed by 50-200 mg bid IV. MRI and CT scan information was available in 125 patients; abnormal findings were present in 86 patients, being ischemic stroke the most common pathology. Focal discharges were found in 73 patients, and generalized discharges in 23. Response to lacosamide was successful in 133 cases (60%). A meta-analysis was not performed given the heterogeneity and the fact that most of the papers were single case reports. Conclusions: There is some evidence supporting the use of LCM for the management of Status epilepticus, although studies with stringent methodology are needed.