Epilepsy Information

American Epilepsy Society (Abst. 3.244)

Outcome of status epilepticus in patients treated with lacosamide

Authors: N. R. Thakur, O. Laban-Grant, C. C. Lambrakis, S. Mesad, J. M. Politsky, E. Feoli, M. Evans, S. JeanBaptiste-Berry, E. Segal, E. Fertig, M. Lancman

Status epilepticus (SE) is a neurological emergency that results in significant patient morbidity and mortality. In recent years, newer antiepileptic drugs (AEDs) are being used in early stages of management of status epilepticus. Lacosamide is one of the newer AEDs that is being used in SE management. However, most of the available data is limited to case reports, reviews and a very few retrospective studies. The aim of this study is to present the data about our experiences regarding outcome of status epilepticus with the administration of lacosamide.


Review of Northeast Regional Epilepsy Group database from March, 2007 to May, 2012 identified 36 patients (16 males and 20 females) in multiple medical centers with diagnosis of status epilepticus that were treated with lacosamide. Status epilepticus (SE) diagnosis was confirmed in all cases with VEEG monitoring. Only patients age 18 and above were included in study (range 18-91y,mean age-60y,SD-20). Status Epilepticus outcome was identified as controlled if SE resolved (seizure freedom), or improved (decrease in seizure frequency and clinical improvement), and refractory if no clinical or electrographic improvement was achieved. Data was retrospectively collected on the SE outcome when lacosamide alone was added to other AED's, or lacosamide and another AED(s) were added.

Etiology: Intracranial Hemorrhage-10 (28%), Neoplasm- 7(19%), Toxic/Infectious/inflammatory-8(22%), Hypoxia/anoxia-5 (14%), Stroke-3(8%), Epilepsy-1(3%), Other-2(6%). SE outcome: Resolved SE-22/36(61%), Improved SE-6/36(17%), Controlled SE-28/36(78%), Refractory SE-8/36 (22%) SE was controlled on addition of lacosamide in 11 cases (31%), and remained uncontrolled on addition of lacosamide in 18 cases (49%). In 7 patients (19%) SE was controlled on addition of lacosamide and other AED's.

This study shows that status epilepticus was controlled on the addition of lacosamide in a significant number of patients (31%). Our study concludes that lacosamide is efficacious in treatment of different types of status epilepticus. It can be used as an adjuvant drug in management of refractory status epileptics. However, large multicenter randomized controlled studies are required to further support our findings.