The use of lacosamide in refractory status epilepticus

Haley Goodwin, Holly Hinson, Kenneth M. Shermock, Navaz Karanjia, John J. Lewin

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Case reports suggest lacosamide may have a role in status epilepticus (SE). The purpose of this case series is to describe the use of lacosamide in refractory SE (RSE) at our institution. Methods: Observational study of all patients admitted to the neurosciences intensive care unit with RSE who received at least one dose of lacosamide from October 2009 to September 2010. Results: Nine patients received lacosamide after failure of at least two other agents. Lacosamide was started a median of 2 days (range: 0-14 days) after the onset of SE. The most frequently used dosing regimen was an initial intravenous dose of 200 mg followed by 200 mg every 12 h. Most patients had received 3 (range: 2-5) AEDs prior to lacosamide. Levetiracetam was used prior to lacosamide in all cases. No patients evaluated responded to lacosamide according to our predefined criteria. One patient developed angioedema after receiving two doses; another patient developed angioedema where timing in relation to the lacosamide was unclear. Care was withdrawn in three of the nine patients for reasons unrelated to lacosamide. Lacosamide was continued at discharge on all surviving patients except in one case of angioedema. Conclusions: This is the largest case series to date describing the use of lacosamide in patients with RSE. Despite the novel mechanism of action, we observed no evidence that lacosamide is effective in RSE; however, our sample size was small. Further study is needed to determine the role of lacosamide in SE, especially early in the treatment course.

Original languageEnglish (US)
Pages (from-to)348-353
Number of pages6
JournalNeurocritical Care
Volume14
Issue number3
DOIs
StatePublished - Jun 2011
Externally publishedYes

Fingerprint

Status Epilepticus
Angioedema
etiracetam
lacosamide
Neurosciences
Sample Size
Observational Studies
Intensive Care Units

Keywords

  • Angioedema
  • Lacosamide
  • Neurology
  • Seizures
  • Status epilepticus

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Goodwin, H., Hinson, H., Shermock, K. M., Karanjia, N., & Lewin, J. J. (2011). The use of lacosamide in refractory status epilepticus. Neurocritical Care, 14(3), 348-353. https://doi.org/10.1007/s12028-010-9501-8

The use of lacosamide in refractory status epilepticus. / Goodwin, Haley; Hinson, Holly; Shermock, Kenneth M.; Karanjia, Navaz; Lewin, John J.

In: Neurocritical Care, Vol. 14, No. 3, 06.2011, p. 348-353.

Research output: Contribution to journalArticle

Goodwin, H, Hinson, H, Shermock, KM, Karanjia, N & Lewin, JJ 2011, 'The use of lacosamide in refractory status epilepticus', Neurocritical Care, vol. 14, no. 3, pp. 348-353. https://doi.org/10.1007/s12028-010-9501-8
Goodwin, Haley ; Hinson, Holly ; Shermock, Kenneth M. ; Karanjia, Navaz ; Lewin, John J. / The use of lacosamide in refractory status epilepticus. In: Neurocritical Care. 2011 ; Vol. 14, No. 3. pp. 348-353.
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