Abstract Details

Title Use of Lacosamide in Neonatal Seizures

Topic Child Neurology and Developmental Neurology

Presentation(s) P6 - Poster Session 6 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-001

Background Lacosamide is an antiseizure medication that was approved by the Food and Drug Administration in 2008. It has been used extensively in adults due to its efficacy, lack of drug interactions, and favorable side effect profile. There has also been research investigating its use in children over 4 years of age. However, there is a paucity of data of its use in the neonatal population.

Objective To investigate lacosamide dosing regimens utilized in neonates along with its safety and efficacy in the neonatal population.

Design/Methods The charts of patients who first received lacosamide at or before 46 weeks postmenstrual age were reviewed and data was extracted manually. A total of 18 unique patients from Parkland Memorial Hospital and Children’s Medical Center in Dallas were included in this study (ranging from 27 to 46 weeks). Efficacy was assessed by determining approximate percentage reduction in seizure burden after initiation of lacosamide (non-responders, reduction <50%, reduction > 50%).

Results Loading doses ranging from 4-10 mg/kg were used in 16 of the 18 patients (88.9%), with an average of 5.5 mg/kg. A loading dose of 10 mg/kg was used in 4 (25%) patients. The maximum dose of lacosamide ranged from 2 to 11 mg/kg/day divided twice daily, with an average of 7.42 mg/kg/day. Lacosamide was, on average, the third line agent used in treating seizures, after phenobarbital and levetiracetam. There were no reported side effects to lacosamide in our 18 patients. Seizure reduction of greater than 50% was seen in 11 patients (61.1%).

Conclusions Lacosamide was a well-tolerated adjunctive medication for treating seizures in our neonatal population with a greater than 50% reduction in seizure seen in 61%. Dosing regimens in neonates were similar to those utilized in older children.

Authors/Disclosures
Abdullah B. Shoaib, MD PRESENTER	Dr. Shoaib has nothing to disclose.
Alison M. Dolce, MD	Dr. Dolce has nothing to disclose.
Michelle Machie, MD (University of Texas Southwestern, Division of Pediatric Neurology)	Dr. Machie has nothing to disclose.
Jennifer L. Thomas, MD (UT Southwestern Medical Center)	Dr. Thomas has nothing to disclose.