Intravenous Lacosamide Therapy for Pediatric Patients With Cluster Seizures

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2024-05-09 DOI:10.1016/j.pediatrneurol.2024.05.003

Ryuki Matsuura MD, PhD , Shin-ichiro Hamano MD, PhD , Kenjiro Kikuchi MD, PhD , Rikako Takeda MD , Hirokazu Takeuchi MD , Yuko Hirata MD, PhD , Reiko Koichihara MD , Takehiro Niitsu MD , Ikuya Ueta MD , Akira Oka MD, PhD

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Abstract

Background

Few studies have investigated intravenous lacosamide use to treat cluster seizures in pediatric patients. Therefore, we aimed to investigate the efficacy and safety of intravenous lacosamide therapy in pediatric patients with cluster seizures.

Methods

We retrospectively evaluated the efficacy and safety of intravenous lacosamide therapy in 25 pediatric patients with cluster seizures at Saitama Children's Medical Center between March 2019 and June 2023. Cluster seizures were defined as a single seizure of less than five minutes duration, repeated three or more times within 12 hours, with recovery of consciousness between seizures. Response was defined as seizure freedom for at least 12 hours after lacosamide infusion.

Results

The median age at onset of epilepsy was 1.5 (0.0 to 9.8) years. The median seizure frequency was 5 (3 to 20) times per 12 hours. The etiologies were remote (n = 17), acute (n = 4), and progressive (n = 4). The median age at which intravenous lacosamide therapy was administered was 4.2 (0.0 to 11.3) years. The median lacosamide dose was 2.6 (1.3 to 5.2) mg/kg. In total, 12 of 25 patients (48.0%) responded. Among patients treated with intravenous lacosamide as first-line therapy, nine of 17 (52.9%) had complete seizure remission. The frequency of complete seizure remission in patients with remote etiologies was 58.8% (10 of 17); among them, seven of 12 (58.3%) patients with structural abnormalities showed complete seizure remission. No adverse events were observed.

Conclusions

Intravenous lacosamide therapy is a potentially useful treatment option for cluster seizures in pediatric patients.

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静脉注射拉科酰胺治疗小儿癫痫群发患者

背景很少有研究调查过静脉注射拉科酰胺治疗儿童患者的集束性癫痫发作。方法我们回顾性评估了 2019 年 3 月至 2023 年 6 月期间琦玉儿童医学中心对 25 名集群发作的儿科患者进行静脉注射拉科酰胺治疗的有效性和安全性。群集性癫痫发作定义为持续时间少于五分钟的单次癫痫发作，在12小时内重复发作三次或三次以上，发作间歇期意识恢复。结果癫痫发病年龄中位数为1.5（0.0至9.8）岁。癫痫发作频率中位数为每12小时5次（3至20次）。病因为远期（17 例）、急性（4 例）和进行性（4 例）。静脉注射拉科酰胺的中位年龄为4.2（0.0至11.3）岁。拉科酰胺的中位剂量为2.6（1.3至5.2）毫克/千克。在25名患者中，共有12人（48.0%）出现了反应。在接受静脉注射拉科酰胺一线治疗的患者中，17人中有9人（52.9%）的癫痫发作完全缓解。在有远期病因的患者中，发作完全缓解的比例为58.8%（17人中有10人）；其中，12名有结构异常的患者中有7人（58.3%）的发作完全缓解。结论静脉注射拉科酰胺疗法是治疗儿童患者群集性癫痫发作的一种潜在有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.