Abstract：
Lacosamide, a voltage-gated sodium channel inhibitor, is an anti-seizure medication (ASM) from the age of 4. We report on the case of a woman treated with lacosamide for pharmacoresistant epilepsy who breastfed her infant for more than 6 months after birth. The infant\'s blood concentrations of lacosamide were 2.4 mg/L on Day 1 and less than 1 mg/L on Day 10 (reference values are 1-10 mg/L). No adverse drug reactions (ADRs) were reported for the infant. Eight cases of breastfeeding by mothers receiving lacosamide are described in the literature. These data confirm that a significant amount of lacosamide seems to pass into breast milk, with a relative infant dose (RID) above 20% in two cases but a low RID (1.8%) in another case. Nevertheless, blood tests, performed in two breastfed infants, revealed low concentrations of lacosamide. No ADRs were reported in eight of the breastfed infants; however, one infant, whose mother was also treated with levetiracetam, presented poor feeding and sleepiness at Day 15 of life. Given the well-known benefits of breastfeeding for both mothers and their infants, as well as the above reassuring data, breastfeeding of healthy full-term infants could be possible for mothers on lacosamide monotherapy. Nonetheless, relatives should be warned that data concerning the safety of lacosamide during breastfeeding are scarce and that long-term neurodevelopment outcomes in breastfed children are unknown. Clinical monitoring of breastfed infants for drowsiness, adequate weight gain, or cutaneous rash is recommended. Additionally, the infants\' serum levels should be measured in case of an unexplained adverse reaction.
摘要：
拉科沙胺,电压门控钠通道抑制剂，是从4岁开始的抗癫痫药物（ASM）。我们报告了一例接受拉科沙胺治疗药物耐药性癫痫的妇女，该妇女在出生后母乳喂养婴儿超过6个月。婴儿在第1天的血液中拉科沙胺的浓度为2.4mg/L，在第10天小于1mg/L（参考值为1-10mg/L）。婴儿未报告药物不良反应（ADR）。文献中描述了8例接受拉科沙胺的母亲母乳喂养的情况。这些数据证实，大量的拉科沙胺似乎进入母乳，在两种情况下，相对婴儿剂量（RID）高于20％，但在另一种情况下RID较低（1.8％）。然而，验血,在两个母乳喂养的婴儿中进行，显示低浓度的拉科沙胺。8名母乳喂养的婴儿没有报告不良反应；然而，一个婴儿,他的母亲也接受了左乙拉西坦治疗，在生命的第15天表现出不良的喂养和嗜睡。鉴于众所周知的母乳喂养对母亲和婴儿的好处，以及上述令人放心的数据，对于接受拉科沙胺单药治疗的母亲来说,健康的足月婴儿的母乳喂养是可能的.尽管如此，应提醒亲属,有关母乳喂养期间使用拉科沙胺安全性的数据很少,母乳喂养儿童的长期神经发育结局尚不清楚.母乳喂养婴儿嗜睡的临床监测，足够的体重增加，或建议皮肤皮疹。此外,如果出现无法解释的不良反应，应测量婴儿的血清水平。
