title: Efficacy and safety of lacosamide as an adjunctive therapy for refractory focal epilepsy in paediatric patients: a retrospective single-centre study.
abstract: OBJECTIVE
  Lacosamide is an antiepileptic drug approved for the treatment of focal epilepsy in adult patients. The aim of this observational study was to review our centre's experience with lacosamide and to characterize its effectiveness and tolerability as an adjunctive antiepileptic drug in a retrospective cohort of children with refractory focal epilepsy.
  
  
  METHODS
  We retrospectively reviewed the medical records of 22 patients who received lacosamide from November 2009 to April 2014 at the CHU Ste-Justine, University of Montreal. Treatment responders were defined as children with a ≥50% reduction in seizure frequency compared to baseline, and this was determined three months after the initiation of treatment and at the last follow-up visit.
  
  
  RESULTS
  We included 14 boys and eight girls with a mean age of 12.9 years (SD: 5.2; range: 5.2-20.7 years) at the initiation of treatment. The average length of follow-up was 11.9 months. Patients had previously received an average of 7.5 antiepileptic drugs. The mean number of concomitant antiepileptic drugs was 2.3. The mean initial and maintenance doses were 2.9 and 8.4 mg/kg/d, respectively. Thirteen (59%) and ten (45%) patients were responders after three months of treatment and at the last follow-up visit, respectively. One became seizure-free. Adverse effects were reported in 11 patients and none were severe. Responders and non-responders were identical with respect to all studied parameters except gender, with the proportion of responders being greater in girls than in boys (75% vs 29%; p=0.035).
  
  
  CONCLUSIONS
  Our study adds evidence that lacosamide appears to be a safe and effective adjunctive therapy for children with refractory focal epilepsy.
authors.affiliation: CHU Sainte-Justine Research Center.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Toupin
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Lortie
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Major
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Paola
authors.initials: P
authors.lastname: Diadori
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Vanasse
authors.affiliation: CHU Sainte-Justine Research Center, Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Elsa
authors.initials: E
authors.lastname: Rossignol
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: D'Anjou
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Perreault
authors.affiliation: Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Albert
authors.initials: A
authors.lastname: Larbrisseau
authors.affiliation: CHU Sainte-Justine Research Center, Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Lionel
authors.initials: L
authors.lastname: Carmant
authors.affiliation: CHU Sainte-Justine Research Center, Division of Neurology, Department of Neurosciences and Paediatrics, CHU Sainte Justine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Ala
authors.initials: A
authors.lastname: Birca
mesh_terms: D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D055423:Diet, Ketogenic; D000069279:Drug Resistant Epilepsy / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D004828:Epilepsies, Partial / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: antiepileptic drug; lacosamide; pediatric patients; refractory epilepsy; treatment