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2014 | 22 | 1 | 51-55

Article title

Successful treatment with adjunctive lacosamide in a patient with long term “drug resistant” focal epilepsy

Content

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Languages of publication

EN

Abstracts

EN
Introduction. A significant number of patients suffering from epilepsy prove to be resistant to antiepileptic drugs (AEDs). Recent studies, however, suggest that 10–20% of seemingly drug resistant patients may still become seizure-free under the influence of subsequent dosage modifications.Case report. We report on a young man with cryptogenic focal epilepsy. He had his first seizure at the age of fifteen. His seizure frequency was decreased during the following 11 years. However, seizure-freedom was never achieved even though he was treated with twelve to fourteen different AEDs during this time. Intensive presurgical evaluations did not allow identification of a surgically remediable focus. Adjunctive treatment with lacosamide 400 mg/day was not successful. However, the patient became seizure-free immediately after an increase of the lacosamide dose up to 500 mg/day. The patient is now seizure-free for more than two years based on a combination of 500 mg lacosamide and 350 mg lamotrigine, followed by 550 mg and 250 mg, respectively.Discussion and conclusion. This case report highlights that there is always a chance that modifying the medication can result in a drug-resistant epilepsy patient experiencing a significant reduction of seizures and becoming seizure-free. The decisive step in this example was the off-label prescription of a high dose of lacosamide which the patient tolerated well.

Keywords

Publisher

Year

Volume

22

Issue

1

Pages

51-55

Physical description

Dates

published
1 - 6 - 2014
online
1 - 3 - 2015
received
11 - 2 - 2014
accepted
5 - 3 - 2014

Contributors

  • Lake Constance Epilepsy Centre/Epilepsiezentrum Bodensee, Centre of Psychiatry Südwürttemberg, Ravensburg-Weissenau, Germany
author
  • Neurological and psychiatric practice, Markdorf, Germany

References

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Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_1515_joepi-2015-0014
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