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

• Authors: Walter Fröscher , Alois Rauber
• 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

EN

epilepsy; drug resistance; lacosamide

• Publisher: De Gruyter Open
• Journal: Journal of Epileptology
• Year: 2014
• Volume: 22
• Issue: 1
• Pages: 51-55

Dates

published

1 - 6 - 2014

online

1 - 3 - 2015

received

11 - 2 - 2014

accepted

5 - 3 - 2014

Contributors

author

Walter Fröscher

• Lake Constance Epilepsy Centre/Epilepsiezentrum Bodensee, Centre of Psychiatry Südwürttemberg, Ravensburg-Weissenau, Germany

author

Alois Rauber

• Neurological and psychiatric practice, Markdorf, Germany

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Identifiers

DOI

10.1515/joepi-2015-0014