Safe, effective lacosamide for childhood epilepsy with centrotemporal spikes


Disclosures: Okanishi reports receiving conference fees from UCB Japan and Daiichi Sankyo. Please see the study for relevant financial information from all other authors.

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According to a study published in brain and development.

“Childhood epilepsy with centrotemporal spikes is an age-limited epilepsy syndrome”, Tohru OkanishiMD, PhD, associate professor of childhood neurology at Tottori University in Japan, and colleagues wrote. “Although the use of antiepileptics is not always recommended, the frequency of the seizures, the diurnal seizures or the evolution towards bilateral tonic-clonic seizures justify the use of medical treatments.”

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Seeking to examine the safety and efficacy of lacosamide monotherapy for the treatment of childhood epilepsy with centrotemporal spikes (CECTS), Okanishi and colleagues conducted a multicenter retrospective study that included 18 children (12 boys, 6 girls ; mean age, 7), all of whom developed seizures between the ages of 3 and 13. Additionally, all participants had minimal hemifacial or oropharyngeal seizures and interictal discharges in the central and/or middle temporal electrodes, had no intellectual disability, and were treated with lacosamide for 6 months.

Researchers started participants on lacosamide at 2 mg/kg per day twice daily and increased it to 4 mg/kg per day in patients weighing 30-50 kg and to 6 mg/kg per day in patients weighing less than 30 kg. They measured the occurrence of seizures at 0 to 3 months, 4 to 6 months and 7 to 12 months after the start of treatment as well as during the last 6 months of follow-up.

Results showed that 39% of participants were seizure-free from onset to 3 months, 67% were seizure-free between 4-6 months, and 72% were seizure-free between 7-12 months. In addition, 72% of patients achieved seizure freedom within 4 months of treatment, while 83% lost their seizures at last follow-up.

Four patients (22%) experienced adverse events including somnolence and fatigue; however, symptoms resolved within 4 weeks. No cognitive disturbances were observed during the maintenance treatment period and no serious adverse effects were observed in any patient. All patients continued lacosamide treatment during follow-up.

“Due to its efficacy, few adverse effects, and tolerability, lacosamide may be an appropriate first-line drug for CECTS,” Okanishi and colleagues wrote.

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