Introduction: RSE is life threatening and quite common emergency in neurology, in the intensive care units (ICUs), with high morbidity and mortality. The treatment of refractory status epilepticus (RSE), defined as status epilepticus (SE) persisting despite use of two lines of anticonvulsant drug, remains challenging. Lacosamide (LCM) is a new AED which has been shown to significantly reduce seizure frequency in patients. with uncontrolled partial-onset seizures. Aim: Aim of this prospective study was to evaluate the efficacy and safety of two initial loading doses, 200 and 400 mg of iv Lacosamide. Material and methods: The present study was carried out on 31 patients of RSE, who were admitted in the Emergency Medical Department or Neurology ward, of our tertiary care hospital (Postgraduate Institute of Medical Education and Research, Chandigarh). A first group received an IV load of 200 mg of LCM. After the initial part of the study, a second group received a loading dose of 400 mg. Outcome measures included efficacy as response rate, and adverse effects. Results: Our results showed that Patients in the group 2 were found to be more ill than in the group 2. In 11 of 31 patients (35.8 %) showed control of seizures and thus responded to treatment with LCM. It was observed that greater response rate to LCM was observed in the 400 mg group [7/16 (43.7 %) in group 2 in comparison to vs. 4/15 (26.6 %)] within 24 hr after LCM introduction. Conclusion: We conclude that loading dose of 400 mg of LCM proved to be better and was associated with early termination of RSE and with no significant increase in toxicity in patients. LCM proves to a promising drug with better efficacy even in higher dosage. More such dosage related studies are required to validate our results, as this study has its own limitations due to small sample size.
Key words: Intravenous Lacosamide, Refractory Status Epilepticus
Received: 26 February, 2019 Revised: 29 March, 2019 Accepted: 30 March, 2019
Corresponding author: Dr. Amit Sharma, Senior Resident, Department of Neurology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
This article may be cited as: Sharma A, Singh P, Goyal MK, Lal V. A Dose Dependent Comparison of Intravenous Lacosamide in Refractory Status Epilepticus. J Adv Med Dent Scie Res 2019;7(5): 32-36.