Abstract：
BACKGROUND: Few studies have investigated intravenous lacosamide use to treat cluster seizures in pediatric patients. Therefore, we aimed to investigate the efficacy and safety of intravenous lacosamide therapy in pediatric patients with cluster seizures.
METHODS: We retrospectively evaluated the efficacy and safety of intravenous lacosamide therapy in 25 pediatric patients with cluster seizures at Saitama Children\'s Medical Center between March 2019 and June 2023. Cluster seizures were defined as a single seizure of less than five minutes duration, repeated three or more times within 12 hours, with recovery of consciousness between seizures. Response was defined as seizure freedom for at least 12 hours after lacosamide infusion.
RESULTS: The median age at onset of epilepsy was 1.5 (0.0 to 9.8) years. The median seizure frequency was 5 (3 to 20) times per 12 hours. The etiologies were remote (n = 17), acute (n = 4), and progressive (n = 4). The median age at which intravenous lacosamide therapy was administered was 4.2 (0.0 to 11.3) years. The median lacosamide dose was 2.6 (1.3 to 5.2) mg/kg. In total, 12 of 25 patients (48.0%) responded. Among patients treated with intravenous lacosamide as first-line therapy, nine of 17 (52.9%) had complete seizure remission. The frequency of complete seizure remission in patients with remote etiologies was 58.8% (10 of 17); among them, seven of 12 (58.3%) patients with structural abnormalities showed complete seizure remission. No adverse events were observed.
CONCLUSIONS: Intravenous lacosamide therapy is a potentially useful treatment option for cluster seizures in pediatric patients.
METHODS: We retrospectively evaluated the efficacy and safety of intravenous lacosamide therapy in 25 pediatric patients with cluster seizures at Saitama Children\'s Medical Center between March 2019 and June 2023. Cluster seizures were defined as a single seizure of less than five minutes duration, repeated three or more times within 12 hours, with recovery of consciousness between seizures. Response was defined as seizure freedom for at least 12 hours after lacosamide infusion.
RESULTS: The median age at onset of epilepsy was 1.5 (0.0 to 9.8) years. The median seizure frequency was 5 (3 to 20) times per 12 hours. The etiologies were remote (n = 17), acute (n = 4), and progressive (n = 4). The median age at which intravenous lacosamide therapy was administered was 4.2 (0.0 to 11.3) years. The median lacosamide dose was 2.6 (1.3 to 5.2) mg/kg. In total, 12 of 25 patients (48.0%) responded. Among patients treated with intravenous lacosamide as first-line therapy, nine of 17 (52.9%) had complete seizure remission. The frequency of complete seizure remission in patients with remote etiologies was 58.8% (10 of 17); among them, seven of 12 (58.3%) patients with structural abnormalities showed complete seizure remission. No adverse events were observed.
CONCLUSIONS: Intravenous lacosamide therapy is a potentially useful treatment option for cluster seizures in pediatric patients.
摘要：
背景：很少有研究研究静脉使用拉考沙胺治疗小儿患者的集束性癫痫发作。因此,我们的目的是探讨拉科沙胺静脉注射治疗儿童集束性癫痫的疗效和安全性.
方法：我们回顾性评估了2019年3月至2023年6月在Sa玉儿童医疗中心进行的25例丛集性癫痫患儿的静脉拉科沙胺治疗的疗效和安全性。集群性癫痫发作定义为持续时间少于五分钟的单次癫痫发作，在12小时内重复三次或更多次，癫痫发作之间的意识恢复。反应定义为输注拉科沙胺后至少12小时无癫痫发作。
结果：癫痫发作的中位年龄为1.5（0.0至9.8）岁。中位发作频率为每12小时5次（3至20次）。病因偏远(n=17)，急性（n=4），和渐进式（n=4）。给予拉科沙胺静脉治疗的中位年龄为4.2(0.0至11.3)岁。拉科沙胺的中位剂量为2.6（1.3至5.2）mg/kg。总的来说,25例患者中有12例（48.0％）有反应。在以静脉注射拉科沙胺作为一线治疗的患者中，17人中有9人(52.9%)的癫痫发作完全缓解.远端病因患者癫痫完全缓解的频率为58.8%(17个中的10个);其中,12例结构异常患者中有7例(58.3%)出现癫痫完全缓解.没有观察到不良事件。
结论：静脉用拉科沙胺治疗是治疗儿童患者丛集性癫痫的潜在有用的治疗选择。
方法：我们回顾性评估了2019年3月至2023年6月在Sa玉儿童医疗中心进行的25例丛集性癫痫患儿的静脉拉科沙胺治疗的疗效和安全性。集群性癫痫发作定义为持续时间少于五分钟的单次癫痫发作，在12小时内重复三次或更多次，癫痫发作之间的意识恢复。反应定义为输注拉科沙胺后至少12小时无癫痫发作。
结果：癫痫发作的中位年龄为1.5（0.0至9.8）岁。中位发作频率为每12小时5次（3至20次）。病因偏远(n=17)，急性（n=4），和渐进式（n=4）。给予拉科沙胺静脉治疗的中位年龄为4.2(0.0至11.3)岁。拉科沙胺的中位剂量为2.6（1.3至5.2）mg/kg。总的来说,25例患者中有12例（48.0％）有反应。在以静脉注射拉科沙胺作为一线治疗的患者中，17人中有9人(52.9%)的癫痫发作完全缓解.远端病因患者癫痫完全缓解的频率为58.8%(17个中的10个);其中,12例结构异常患者中有7例(58.3%)出现癫痫完全缓解.没有观察到不良事件。
结论：静脉用拉科沙胺治疗是治疗儿童患者丛集性癫痫的潜在有用的治疗选择。
