Abstract：
BACKGROUND: Lacosamide is an antiepileptic drug with US Food and Drug Administration approval for the treatment of partial-onset seizures in patients older than one month. Lacosamide works by selective enhancement of proteins that induce preferential slow promotion of sodium channels to the hyperpolarized inactive state. Lacosamide is generally well-tolerated; however, clinical and nonclinical studies have linked its use with cardiac side effects including PR prolongation and atrioventricular (AV) block.
RESULTS: We present the case of a three-week-old female neonatal patient born at 25 weeks\' gestation who developed second-degree AV heart block and cardiac arrest after initiating lacosamide therapy. The patient was being treated for neonatal seizure complicated by intraventricular hemorrhage (grade II) and electrolyte disturbances with phenobarbital, levetiracetam, and phenytoin. Before addition of lacosamide therapy, the patient had an unremarkable electrocardiogram and no known cardiac risk factors for lacosamide. After medication discontinuation, the patient experienced no reoccurring episodes or other cardiac events.
CONCLUSIONS: Use of lacosamide for neonatal populations is currently under evaluation. This is the first report of adverse cardiac event (AV block) in the setting of neonatal lacosamide use. Risk of future adverse cardiac events should be evaluated when determining the safety and efficacy of lacosamide in the neonatal population.
RESULTS: We present the case of a three-week-old female neonatal patient born at 25 weeks\' gestation who developed second-degree AV heart block and cardiac arrest after initiating lacosamide therapy. The patient was being treated for neonatal seizure complicated by intraventricular hemorrhage (grade II) and electrolyte disturbances with phenobarbital, levetiracetam, and phenytoin. Before addition of lacosamide therapy, the patient had an unremarkable electrocardiogram and no known cardiac risk factors for lacosamide. After medication discontinuation, the patient experienced no reoccurring episodes or other cardiac events.
CONCLUSIONS: Use of lacosamide for neonatal populations is currently under evaluation. This is the first report of adverse cardiac event (AV block) in the setting of neonatal lacosamide use. Risk of future adverse cardiac events should be evaluated when determining the safety and efficacy of lacosamide in the neonatal population.
摘要：
背景：Lacosamide是一种获得美国食品和药物管理局批准的抗癫痫药物，用于治疗1个月以上患者的部分发作性癫痫。拉科酰胺通过选择性增强诱导优先缓慢促进钠通道至超极化非活性状态的蛋白质起作用。Lacosamide通常耐受性良好;然而，临床和非临床研究已将其使用与心脏副作用相关,包括PR延长和房室传导阻滞.
结果：我们介绍了一例在妊娠25周时出生的3周龄女性新生儿患者，在开始拉科沙胺治疗后出现二级房室传导阻滞和心脏骤停。该患者正在接受苯巴比妥治疗，因新生儿癫痫发作并发脑室内出血（II级）和电解质紊乱，左乙拉西坦,还有苯妥英.在加用拉科沙胺治疗之前,患者的心电图无明显变化,并且没有已知的拉科沙胺心脏危险因素.停药后，患者未出现反复发作或其他心脏事件.
结论：目前正在评估在新生儿人群中使用拉科沙胺。这是新生儿使用拉科沙胺的情况下不良心脏事件（房室传导阻滞）的第一份报告。在确定拉科沙胺在新生儿人群中的安全性和有效性时，应评估未来不良心脏事件的风险。
结果：我们介绍了一例在妊娠25周时出生的3周龄女性新生儿患者，在开始拉科沙胺治疗后出现二级房室传导阻滞和心脏骤停。该患者正在接受苯巴比妥治疗，因新生儿癫痫发作并发脑室内出血（II级）和电解质紊乱，左乙拉西坦,还有苯妥英.在加用拉科沙胺治疗之前,患者的心电图无明显变化,并且没有已知的拉科沙胺心脏危险因素.停药后，患者未出现反复发作或其他心脏事件.
结论：目前正在评估在新生儿人群中使用拉科沙胺。这是新生儿使用拉科沙胺的情况下不良心脏事件（房室传导阻滞）的第一份报告。在确定拉科沙胺在新生儿人群中的安全性和有效性时，应评估未来不良心脏事件的风险。
