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Usefulness of intravenous lacosamide in status epilepticus

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Abstract

Lacosamide (LCM) is a treatment option for status epilepticus (SE) described in several series. We therefore proposed to describe its use in status epilepticus patients in our hospital. All patients admitted to our hospital for SE from September 2010 to April 2012 were evaluated. We collected related variables including the type of SE, etiology, antiepileptic drugs (AEDs) used, loading dose of AEDs, cessation of SE after AEDs, ICU admission and mortality. In those patients receiving LCM, we reviewed the infusion rate and time to response. We compared patients receiving LCM with patients in whom it was not used. This was a retrospective and uncontrolled study. A total of 92 patients were included; 67.7 % of SE patients who received LCM responded to treatment. The vast majority of the patients presented non-convulsive and motor focal SE. When we selected patients to receive four or more AEDs, the LCM efficacy was 55.6 %, a very similar result compared to when it was not used. Subsequently, we analyzed the sample regarding the AED administered as the second or third line of treatment, and the responder rate was significantly higher when LCM was used (84.6 vs. 47.8 %, p 0.041). After an adjusted regression analysis, the use of LCM was independently associated with cessation of SE. The total percentage of undesirable effects was very low (12 %), and they were all mild. No relationship was found between a specific etiology and better response. LCM is a useful drug that represents an alternative in the treatment of non-convulsive or focal motor SE. Its efficacy might be more important when it is administered as a second or third option after benzodiazepines. A randomized trial is required to confirm these results.

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Conflicts of interest

None of the authors has any conflict of interest to disclose.

Ethical standard

The study was approved by the local ethics committee and was therefore performed in accordance with ethical standards according to WMA Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects.

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Authors and Affiliations

  1. Epilepsy Unit, Department of Neurology, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Estevo Santamarina, Manuel Toledo, Manuel Quintana, Javier Alvarez-Sabín & Xavier Salas Puig

  2. Department of Clinic Neurophysiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Maria Sueiras, Nadim Ailouti & Elena Lainez

  3. Department of Neuropediatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Miquel Raspall

  4. Intensive Care Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Isabel Porta & R. de Gracia

Authors
  1. Estevo Santamarina
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  2. Manuel Toledo
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  3. Maria Sueiras
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  4. Miquel Raspall
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  5. Nadim Ailouti
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  6. Elena Lainez
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  7. Isabel Porta
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  8. R. de Gracia
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  9. Manuel Quintana
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  10. Javier Alvarez-Sabín
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  11. Xavier Salas Puig
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Corresponding author

Correspondence to Estevo Santamarina.

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Santamarina, E., Toledo, M., Sueiras, M. et al. Usefulness of intravenous lacosamide in status epilepticus. J Neurol 260, 3122–3128 (2013). https://doi.org/10.1007/s00415-013-7133-6

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  • DOI: https://doi.org/10.1007/s00415-013-7133-6

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