title: Intravenous lacosamide as treatment option in post-stroke non convulsive status epilepticus in the elderly: a proof-of-concept, observational study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intravenously administered lacosamide (iv LCM) in post-stroke non convulsive status epilepticus (NCSE) in elderly patients.
  
  
  METHODS
  We enrolled 16 patients (7 M/9 F; 77 ± 7 years of age) with NCSE. iv LCM was used in all the patients as initial treatment (i.e. patients were directly started on LCM) at a loading dose of 400 mg over 30 min, followed by a mean maintenance dose of 400 mg per day. iv LCM was considered as effective in patients who experience no NCSE for 24 h following treatment, as evaluated by EEG recording and clinical observation.
  
  
  RESULTS
  LCM was effective in treating NCSE in eight of the sixteen patients in whom epileptic activity disappeared (7/8) or was significantly reduced (1/8) within 45-60 min after administration. None of these patients relapsed in the following 24 h. No adverse events were observed. A partial anterior circulation syndrome (PACS) was present in 10 patients while a total anterior circulation syndrome (TACS) in six.
  
  
  CONCLUSIONS
  This pilot study suggests that LCM exhibits safety and efficacy profiles which make it an optimal candidate as a first-choice drug against post-stroke NCSE in elderly patients. A prospective comparative trial is needed to confirm these preliminary data.
authors: Department of Neurosciences, Saint' Anna Hospital, Como, Italy. Electronic address: vincenzobelcastro@libero.it.
authors: Vincenzo
authors: V
authors: Belcastro
authors: Simone
authors: S
authors: Vidale
authors: Laura
authors: L
authors: Pierguidi
authors: Luigi
authors: L
authors: Sironi
authors: Lucia
authors: L
authors: Tancredi
authors: Pasquale
authors: P
authors: Striano
authors: Angelo
authors: A
authors: Taborelli
authors: Marco
authors: M
authors: Arnaboldi
mesh_terms: D000081:Acetamides / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D013226:Status Epilepticus / Q000188:drug therapy* / Q000209:etiology; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: Antiepileptic drugs; Benzodiazepines; Lacosamide; Non convulsive status epilepticus; Post-stroke seizures