Clinical Experience With Lacosamide as an Adjunct Treatment for Neonatal Seizures: A Retrospective Single-Center Study

Pediatr Neurol. 2024 Aug:157:134-140. doi: 10.1016/j.pediatrneurol.2024.05.019. Epub 2024 Jun 5.

Abstract

Background: Lacosamide (LCM) is a third-generation antiseizure medication (ASM) currently approved for the treatment of focal seizures in children aged greater than one month. There are limited data on its efficacy in the neonatal age group. We describe our experience with LCM as an adjunct ASM for the treatment of neonatal seizures.

Methods: A retrospective chart review over a five-year period (2018 to 2022) was conducted at Le Bonheur Children's Hospital to identify neonates with electroencephalography (EEG)-proven seizures who were treated with LCM. Data were collected on electroclinical seizure characteristics, underlying etiology, ASMs, treatment response, and any adverse effects.

Results: A total of 15 neonates with EEG-confirmed seizures who were treated with LCM were included. Ten neonates achieved seizure cessation after LCM was added to their ASM regimen consisting of phenobarbital, levetiracetam, or both. No new treatment-related adverse effects were noted.

Conclusions: LCM is effective as an adjunct treatment for neonatal seizures. Randomized controlled studies are needed to establish its effectiveness and adequate dosing regimen in this population.

Keywords: Antiseizure medication; Lacosamide; Lacosamide pediatric epilepsy; Neonatal seizures.

MeSH terms

  • Anticonvulsants* / administration & dosage
  • Anticonvulsants* / pharmacology
  • Drug Therapy, Combination
  • Electroencephalography*
  • Female
  • Humans
  • Infant, Newborn
  • Lacosamide* / administration & dosage
  • Lacosamide* / pharmacology
  • Levetiracetam / administration & dosage
  • Levetiracetam / pharmacology
  • Male
  • Phenobarbital / administration & dosage
  • Phenobarbital / therapeutic use
  • Retrospective Studies
  • Seizures* / drug therapy

Substances

  • Lacosamide
  • Anticonvulsants
  • Phenobarbital
  • Levetiracetam