title: Lacosamide efficacy in epileptic syndromes with continuous spike and waves during slow sleep (CSWS).
abstract: BACKGROUND
  Epileptic syndromes with continuous spikes-waves during sleep (CSWS) represent a wide spectrum of epileptic disorders having CSWS as a common EEG-feature. Defined therapeutic strategies are still lacking. We evaluated the efficacy of lacosamide add-on therapy on the EEG, behavior, and cognition in children with CSWS.
  
  
  METHODS
  Eight children with CSWS refractory to other conventional antiepileptic drugs were included in the study. A 24-h EEG recording was performed at 6-month-interval in all patients. The spike-wave index (SWI) was obtained in each 24-h EEG recording. Neuropsychological data were obtained before lacosamide introduction and after a minimum of 12 months of therapy.
  
  
  RESULTS
  After a 6-month period of therapy, 75% of patients was defined as responder, 12.5% as partial responder and another 12.5% as non-responder. In particular, 24-h EEG normalized in 3 cases (37%). After a minimum of 12 months, 24-h EEG normalized in another patient while two patients showed electroclinical relapses. A total of 62.5% of patients was therefore defined as responder. Neuropsychological functions slightly improved in 25% of patients.
  
  
  CONCLUSIONS
  Although further studies are needed to validate our observations, this study suggests that lacosamide add-on therapy may be safe and effective in children affected by CSWS.
authors.affiliation: Neurology-Immunology and Endocrinology Unit, University of Siena, Italy; Department of Pediatrics, University of Siena, Italy. Electronic address: grosso@unisi.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grosso
authors.affiliation: Child Neurology, Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza University", Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.affiliation: Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Department of Pediatrics, University of Siena, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: di Bartolo
authors.affiliation: Department of Pediatrics, University of Siena, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Balestri
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D009483:Neuropsychological Tests; D012890:Sleep / Q000187:drug effects / Q000502:physiology*
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: Antiepileptic drugs; ESES; Epilepsy; Epileptic encephalopathy; Pediatrics