title: A case of lacosamide-induced hepatotoxicity.
abstract: BACKGROUND
  Lacosamide is a novel antiepileptic drug that acts mainly via the selective enhancement of slow inactivation of voltage-gated sodium channels. It has been reported that lacosamide is effective and generally tolerable as an adjuvant treatment in patients with partial seizures. There are few reports regarding liver damage caused by lacosamide. We describe a case of a patient with drug-resistant epilepsy who developed symptomatic hepatotoxicity after lacosamide administration.
  
  
  RESULTS
  A 22-year-old female with a 2-year history of temporal lobe epilepsy was admitted to our hospital because of nausea, dizziness, and abnormal liver function tests. Lacosamide was added for further seizure control 9 days before the current presentation. Her liver enzymes were markedly increased: aspartate aminotransferase, 635 U/L; alanine aminotransferase, 697 U/L. Lacosamide was ceased immediately, whereas other medications (zonisamide, clobazam, and tianeptine) were not withdrawn. The level of liver enzymes improved significantly within a few days, and a diagnosis of lacosamide-induced hepatitis was made based on the obvious temporal relationship.
  
  
  CONCLUSIONS
  This case report demonstrates that hepatotoxicity may develop in association with lacosamide therapy. Liver function tests should be prompted in patients with symptoms suggestive of adverse effects after the initiation of lacosamide. Further research is required to identify predisposing factors of lacosamideinduced hepatotoxicity.
authors.forename: Jun-Sang
authors.initials: JS
authors.lastname: Sunwoo
authors.forename: Jung-Ick
authors.initials: JI
authors.lastname: Byun
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000081:Acetamides / Q000009:adverse effects*; D000410:Alanine Transaminase / Q000097:blood; D000927:Anticonvulsants / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D004796:Clinical Enzyme Tests; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008111:Liver Function Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D015415:Biomarkers; D000078334:Lacosamide; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase