Efficacy of Lacosamide in a Patient with Refractory Generalized Epilepsy Based on Video Electroencephalography

A 20-year-old man with drug-resistant generalized epilepsy (GE) was admitted for video electroencephalography (vEEG) monitoring under treatment with multiple antiepileptic drugs, including levetiracetam (3,000 mg/day), valproic acid (800 mg/day), and lacosamide (LCM) (100 mg/day). No seizures were n...

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Bibliographic Details
Published in:Internal Medicine 2021/11/15, Vol.60(22), pp.3621-3624
Main Authors: Yamada, Hidetada, Neshige, Shuichiro, Shishido, Takeo, Ueno, Hiroki, Ohshita, Tomohiko, Morino, Hiroyuki, Maruyama, Hirofumi
Format: Article
Language:English
Subjects:
Adult
Anticonvulsants - therapeutic use
Antiepileptic agents
antiepileptic drug
Case Report
Convulsions & seizures
Drug resistance
Drug withdrawal
EEG
Electroencephalography
Epilepsy
Epilepsy, Generalized - diagnosis
Epilepsy, Generalized - drug therapy
Etiracetam
generalized seizure
generalized spike and wave complex
Humans
ictal EEG
idiopathic generalized epilepsy
Internal medicine
Lacosamide - therapeutic use
Male
Patients
Seizures
Seizures - drug therapy
Titration
Valproic acid
Young Adult
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Summary:A 20-year-old man with drug-resistant generalized epilepsy (GE) was admitted for video electroencephalography (vEEG) monitoring under treatment with multiple antiepileptic drugs, including levetiracetam (3,000 mg/day), valproic acid (800 mg/day), and lacosamide (LCM) (100 mg/day). No seizures were noted after the withdrawal of levetiracetam. However, after the withdrawal of LCM, atypical absence seizures with a 2- to 2.5-Hz generalized spike and wave complex frequently appeared, followed by subsequent generalized-onset tonic-clonic seizures. After re-administration of LCM, the seizures and epileptic discharges clearly disappeared. Subsequent LCM titration was successful in achieving a seizure-free status. Our vEEG results suggest that LCM may be a worthwhile antiepileptic drug adjunct in refractory GE patients without a risk of worsening absence seizures.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.7295-21