PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2014 | 22 | 1 | 51-55
Tytuł artykułu

Successful treatment with adjunctive lacosamide in a patient with long term “drug resistant” focal epilepsy

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Introduction. A significant number of patients suffering from epilepsy prove to be resistant to antiepileptic drugs (AEDs). Recent studies, however, suggest that 10–20% of seemingly drug resistant patients may still become seizure-free under the influence of subsequent dosage modifications. Case report. We report on a young man with cryptogenic focal epilepsy. He had his first seizure at the age of fifteen. His seizure frequency was decreased during the following 11 years. However, seizure-freedom was never achieved even though he was treated with twelve to fourteen different AEDs during this time. Intensive presurgical evaluations did not allow identification of a surgically remediable focus. Adjunctive treatment with lacosamide 400 mg/day was not successful. However, the patient became seizure-free immediately after an increase of the lacosamide dose up to 500 mg/day. The patient is now seizure-free for more than two years based on a combination of 500 mg lacosamide and 350 mg lamotrigine, followed by 550 mg and 250 mg, respectively. Discussion and conclusion. This case report highlights that there is always a chance that modifying the medication can result in a drug-resistant epilepsy patient experiencing a significant reduction of seizures and becoming seizure-free. The decisive step in this example was the off-label prescription of a high dose of lacosamide which the patient tolerated well.
Słowa kluczowe
Wydawca
Rocznik
Tom
22
Numer
1
Strony
51-55
Opis fizyczny
Daty
wydano
2014-06-01
otrzymano
2014-02-11
zaakceptowano
2014-03-05
online
2015-03-01
Twórcy
  • Lake Constance Epilepsy Centre/Epilepsiezentrum Bodensee, Centre of Psychiatry Südwürttemberg, Ravensburg-Weissenau, Germany , w.froescher@arcor.de
autor
  • Neurological and psychiatric practice, Markdorf, Germany
Bibliografia
  • Ben-Menachem E.:Medical management of refractory epilepsy – Practical treatment with novel antiepileptic drugs. Epilepsia, 2014, 55, Suppl 1: 3–8.[WoS]
  • Callaghan B.C., Anand K., Hesdorffer D., Hauser W.A., French J.A.:Likelihood of seizure remission in an adult population with refractory epilepsy. Ann. Neurol., 2007, 62: 382–389.[WoS][Crossref]
  • Chung S.:Lacosamide: new adjunctive treatment option for partial-onset seizures. Expert. Opin. Pharmacother., 2010, 11: 1559–1602.[WoS][Crossref]
  • Chung S., Ben-Menachem E., Sperling M.R., Rosenfeld W., Fountain N.B., Benbadis S. et al.:Examining the clinical utility of lacosamide: Pooled analyses of three phase II/III clinical trials. CNS Drugs, 2010a, 24: 1041–1054.[PubMed][Crossref][WoS]
  • Chung S., Sperling M.R., Biton V., Krauss G., Hebert D., Rudd G.D. et al.:Lacosamide as adjunctive therapy for partial-onset seizures: A randomized controlled trial. Epilepsia, 2010b, 51: 958–967.[Crossref][PubMed]
  • Contin M., Albani F., Riva R., Candela C., Mohamed S., Baruzzi A.:Lacosamide therapeutic monitoring in patients with epilepsy: Effect of concomitant antiepileptic drugs. Ther. Drug Monit., 2013, 35: 849–852.[WoS][PubMed][Crossref]
  • Fröscher W.:Drug resistant epilepsy. Epileptologia, 2012, 20: 17–23.
  • Fröscher W., Auner M., Kirschbaum J.:Behandlungsergebnisse bei pharmakoresistent erscheinenden Patienten (Therapeutic results in apparent drug-refractory epileptics). Akt. Neurol., 1989, 16: 1–8.[Crossref]
  • Fröscher W., Rösche J.:Kombinationstherapie bei Epilepsie (Combination therapy for epilepsy). Fortschr. Neurol. Psychiat., 2013, 80: 9–20.
  • Greenaway C., Ratnaraj N., Sander J.W., Patsalos P.N.:A high-performance liquid chromatography assay to monitor the new antiepileptic drug lacosamide in patients with epilepsy. Ther. Drug Monit., 2010, 32: 448–452.[WoS][Crossref][PubMed]
  • Hoy S.M.:Lacosamide: A review of its use as adjunctive therapy in the management of partial-onset seizures. CNS Drugs, 2013, 27: 1125–1142.[PubMed][WoS][Crossref]
  • Kwan P., Arzimanoglou A., Berg A.T., Brodie M.J., Hauser W.A., Mathern G. et al.:Definition of drug resistant epilepsy: Consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Epilepsia, 2010, 51: 1069–1077.[Crossref][PubMed][WoS]
  • Kwan P., Schachter St.C., Brodie M.J.:Drug resistant epilepsy. N. Engl. J. Med., 2011, 365: 919–926.[Crossref]
  • Luciano A.L., Shorvon S.D.:Results of treatment changes in patients with apparently drug-resistant chronic epilepsy. Ann. Neurol., 2007, 62: 375–381[PubMed][Crossref]
  • Mula M.,Godi L., Onorato S., Savoini G.:Successful treatment of super-refractory status epilepticus with intravenous lacosamide. Epileptologia, 2012, 20: 81–85.
  • Munger Clary H., Choi H.:Prognosis of intractable epilepsy: Is long-term seizure freedom possible with medical management? Clin. Neurol. Neurosci. Rep., 2011, 11: 409–417.[WoS][Crossref]
  • Neligan A., Bell G.S., Sander J.W., Shorvon S.D.:How refractory is refractory epilepsy? Patterns of relapse and remission in people with refractory epilepsy. Epilepsy Res., 2011, 96: 225–230.[PubMed][Crossref]
  • Patsalos P.N.:Drug interactions with the newer antiepileptic drugs (AEDs) – Part 1. Pharmacokinetic and pharmacodynamic interactions between AEDs. Clin. Pharmacokinet., 2013, 52: 927–966.
  • Pedersen B., Rasmussen J.B.:Lacosamide treatment – added value of plasma levels? Epilepsia, 2013, 54, Suppl 3: 171.
  • Sattler A., Schaefer M., May T.W., Rambeck B., Brandt C.:Fluctuation of lacosamide serum concentrations during the day and occurrence of drug reactions – first clinical experience. Epilepsy Res., 2011, 95: 207–212.[Crossref][PubMed][WoS]
  • Schiller Y., Najjar Y.:Quantifying the response to antiepileptic drugs: effect of past treatment history. Neurology, 2008, 70: 54–65.[Crossref][PubMed]
  • Vimpat® product information (Fachinformation). UCB Pharma GmbH, Monheim, Germany. 31.7.2013.
  • Wittstock M., Benecke R., Rösche J.:Transient third-degree atrioventricular block following rapid lacosamide titration in a patient with nonconvulsive status epilepticus. Epileptologia, 2011, 19: 165–169.
  • Zaccara G., Perucca P., Loiacono G., Giovanelli F., Verrotti A.:The adverse event profile of lacosamide: a systematic review and meta-analysis of randomized controlled trials. Epilepsia, 2013, 54: 66–74.[Crossref][PubMed]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_joepi-2015-0014
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.