Efficacy of lacosamide in neonatal‐onset super‐refractory status epilepticus: a case report

We report the case of a previously healthy newborn who developed super‐refractory status epilepticus after Group B streptococcal meningoencephalitis. After administration of first‐, second‐ and third‐line anticonvulsants without resolution of status epilepticus, we started intravenous lacosamide as...

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Bibliographic Details
Published in:Epileptic disorders 2021-08, Vol.23 (4), p.655-660
Main Authors: Bertozzi, Veronica, Bonardi, Claudia M., Biscalchin, Gaia, Tona, Clarissa, Amigoni, Angela, Sartori, Stefano
Format: Article
Language:English
Subjects:
Anticonvulsants
Anticonvulsants - therapeutic use
Case reports
EEG
Epilepsy
Humans
Infant, Newborn
Intravenous administration
Ketamine
Lacosamide
Meningoencephalitis
Midazolam
neonatal
Neonates
newborn
Newborn babies
Phenobarbital
Phenobarbital - therapeutic use
Phenytoin
Seizures - drug therapy
status epilepticus
Status Epilepticus - drug therapy
super refractory status epilepticus
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Summary:We report the case of a previously healthy newborn who developed super‐refractory status epilepticus after Group B streptococcal meningoencephalitis. After administration of first‐, second‐ and third‐line anticonvulsants without resolution of status epilepticus, we started intravenous lacosamide as adjunctive therapy to phenobarbital, phenytoin and continuous infusion of ketamine and midazolam. After administration of lacosamide, we observed a clear‐cut improvement in the neurological clinical condition coupled with seizure control on continuous video‐EEG monitoring, even after suspension of all other medications except for phenobarbital. No adverse effects ascribable to lacosamide were reported. The available data regarding the use of lacosamide for status epilepticus in adults and children are promising, although there is as yet only anecdotal evidence for neonatal status epilepticus. Its lack of potential interactions, good tolerability and the option of intravenous use lend to its appeal as treatment for status epilepticus. To the best of our knowledge, this is one of the first reported cases of effective lacosamide infusion in neonatal‐onset super‐refractory status epilepticus. This evidence should prompt further investigation on efficacy and safety of lacosamide to support its use in this population.
ISSN:1294-9361
1950-6945
DOI:10.1684/epd.2021.1307