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Volume 7 Issue 5 (May, 2019)

Original Articles

Efficacy of Intravenous Lacosamide in Refractory Status Epilepticus Patients
Amit Sharma, Parampreet Singh, Manoj K Goyal, Vivek Lal

Introduction: Refractory status epilepticus (RSE) establishes in 23-43% section of the patients with SE. Lacosamide (LCM) is one of the newer antiepileptic drugs  used for the treatment of such patents. Since its introduction, use of this drug is steadily increasing and it has achieved rapid spread in clinical practice.It has been shown to have a low rate of hemodynamic changes, elevated liver function tests, cardiac arrhythmias, renal dysfunction, and hypersensitivity. Aim: The purpose of this study was to evaluate the effectiveness of lacosamide in terms of laborartory and EEG findings in critically ill patients of refactory status epilepticus. Material and methods: The present study was carried out on 52 patients of RSE. The safety of lacosamide was evaluated in patients by reviewing blood pressure pre-lacosamide and again at 1, 4, and 24 h after lacosamide administration. Liver enzymes and creatinine were evaluated prelacosamide and 1 and 7 days post-lacosamide. Results: The mean age of patients at time of evaluation was 39.73 ± 15.29 (range: 13-70) years and most common identifiable cause of status epilepticus was ischemic stroke. On  day 1 post-lacosamide,  6 patients developed an elevation in liver function testing and by day 7 post-lacosamide, 9 patients had transaminitis. On evaluation of kidney function similarly, Creatinine was  found to  be not significantly different on both day  1 and day 7 post-lacosamide.  EEG was done in 43 (82.69%) patients. Abnormal EEG recordings were in the form of diffuse slowing in 22 (51.16%. After receiving lacosamide, the length of status epilepticus was 31.1 ± 4.6 h. When comparing medication responses at 4, 12, 24, and 48 h in the patients, at 4 h, 17.3 % of lacosamide patients responded while the number increased to 78.8% by 48 h. Conclusion: Lacosamide seems to be an ideal antiepileptic for use in the critically ill. there is a need for a large, prospective study evaluating lacosamide in status epilepticus and comparing the effectiveness to traditional antiepileptics, such as phenytoin.
Key words: Status epilepticus, Refractory status epilepticus, Lacosamide, liver function.

Received: 2 March, 2019                        Revised: 12 April, 2019                          Accepted: 13 April, 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. Efficacy of Intravenous Lacosamide in Refractory Status Epilepticus Patients.  J Adv Med Dent Scie Res 2019;7(5): 131-135.

 
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