Absence status induced by lacosamide adjunctive therapy

Charles A Szabo, Lola Morgan, Suzanne Sonnenberg, Kameel Karkar

Research output: Contribution to journalArticle

Abstract

Since lacosamide was approved as an adjuvant agent for the treatment of medically refractory focal epilepsy over ten years ago, it is becoming more widely used for the treatment of idiopathic (genetic) generalized epilepsies. Several studies have demonstrated efficacy in reducing primary generalized tonic-clonic seizures (GTCS), but efficacy is less well-characterized for myoclonic and absence seizures. A 29-year-old man with juvenile myoclonic epilepsy and medically refractory GTCS on a combination of levetiracetam and topiramate was started on lacosamide adjunctive therapy with the plan to replace topiramate. While his GTCS became controlled, he was witnessed to have confusional episodes, with waxing and waning responsiveness, lasting a few days, several times a month. After eight months of adjunctive lacosamide therapy, he was admitted to the epilepsy monitoring unit, where paroxysms of generalized spike-and-wave complexes, lasting for 30-90 minutes, were recorded, interrupted only by sleep. During these periods, he demonstrated psychomotor slowing and disorientation on examination. The absence status was successfully broken by lorazepam, and lacosamide was discontinued. The patient had no further confusional episodes at the most recent follow-up visit, four months after discharge.

Original languageEnglish (US)
Pages (from-to)97-101
Number of pages5
JournalEpileptic Disorders
Volume21
Issue number1
DOIs
StatePublished - Feb 1 2019

Fingerprint

Status Epilepticus
Seizures
etiracetam
Juvenile Myoclonic Epilepsy
Absence Epilepsy
Lorazepam
Confusion
Partial Epilepsy
Therapeutics
Epilepsy
Sleep
lacosamide
topiramate

Keywords

  • absence status
  • antiepileptic medications
  • idiopathic generalized epilepsy
  • lacosamide
  • seizure aggravation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Szabo, C. A., Morgan, L., Sonnenberg, S., & Karkar, K. (2019). Absence status induced by lacosamide adjunctive therapy. Epileptic Disorders, 21(1), 97-101. https://doi.org/10.1684/epd.2019.1032

Absence status induced by lacosamide adjunctive therapy. / Szabo, Charles A; Morgan, Lola; Sonnenberg, Suzanne; Karkar, Kameel.

In: Epileptic Disorders, Vol. 21, No. 1, 01.02.2019, p. 97-101.

Research output: Contribution to journalArticle

Szabo, CA, Morgan, L, Sonnenberg, S & Karkar, K 2019, 'Absence status induced by lacosamide adjunctive therapy', Epileptic Disorders, vol. 21, no. 1, pp. 97-101. https://doi.org/10.1684/epd.2019.1032
Szabo, Charles A ; Morgan, Lola ; Sonnenberg, Suzanne ; Karkar, Kameel. / Absence status induced by lacosamide adjunctive therapy. In: Epileptic Disorders. 2019 ; Vol. 21, No. 1. pp. 97-101.
@article{dd9f0770d026467ab558c72ceef7c97f,
title = "Absence status induced by lacosamide adjunctive therapy",
abstract = "Since lacosamide was approved as an adjuvant agent for the treatment of medically refractory focal epilepsy over ten years ago, it is becoming more widely used for the treatment of idiopathic (genetic) generalized epilepsies. Several studies have demonstrated efficacy in reducing primary generalized tonic-clonic seizures (GTCS), but efficacy is less well-characterized for myoclonic and absence seizures. A 29-year-old man with juvenile myoclonic epilepsy and medically refractory GTCS on a combination of levetiracetam and topiramate was started on lacosamide adjunctive therapy with the plan to replace topiramate. While his GTCS became controlled, he was witnessed to have confusional episodes, with waxing and waning responsiveness, lasting a few days, several times a month. After eight months of adjunctive lacosamide therapy, he was admitted to the epilepsy monitoring unit, where paroxysms of generalized spike-and-wave complexes, lasting for 30-90 minutes, were recorded, interrupted only by sleep. During these periods, he demonstrated psychomotor slowing and disorientation on examination. The absence status was successfully broken by lorazepam, and lacosamide was discontinued. The patient had no further confusional episodes at the most recent follow-up visit, four months after discharge.",
keywords = "absence status, antiepileptic medications, idiopathic generalized epilepsy, lacosamide, seizure aggravation",
author = "Szabo, {Charles A} and Lola Morgan and Suzanne Sonnenberg and Kameel Karkar",
year = "2019",
month = "2",
day = "1",
doi = "10.1684/epd.2019.1032",
language = "English (US)",
volume = "21",
pages = "97--101",
journal = "Epileptic Disorders",
issn = "1294-9361",
publisher = "Springer Paris",
number = "1",

}

TY - JOUR

T1 - Absence status induced by lacosamide adjunctive therapy

AU - Szabo, Charles A

AU - Morgan, Lola

AU - Sonnenberg, Suzanne

AU - Karkar, Kameel

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Since lacosamide was approved as an adjuvant agent for the treatment of medically refractory focal epilepsy over ten years ago, it is becoming more widely used for the treatment of idiopathic (genetic) generalized epilepsies. Several studies have demonstrated efficacy in reducing primary generalized tonic-clonic seizures (GTCS), but efficacy is less well-characterized for myoclonic and absence seizures. A 29-year-old man with juvenile myoclonic epilepsy and medically refractory GTCS on a combination of levetiracetam and topiramate was started on lacosamide adjunctive therapy with the plan to replace topiramate. While his GTCS became controlled, he was witnessed to have confusional episodes, with waxing and waning responsiveness, lasting a few days, several times a month. After eight months of adjunctive lacosamide therapy, he was admitted to the epilepsy monitoring unit, where paroxysms of generalized spike-and-wave complexes, lasting for 30-90 minutes, were recorded, interrupted only by sleep. During these periods, he demonstrated psychomotor slowing and disorientation on examination. The absence status was successfully broken by lorazepam, and lacosamide was discontinued. The patient had no further confusional episodes at the most recent follow-up visit, four months after discharge.

AB - Since lacosamide was approved as an adjuvant agent for the treatment of medically refractory focal epilepsy over ten years ago, it is becoming more widely used for the treatment of idiopathic (genetic) generalized epilepsies. Several studies have demonstrated efficacy in reducing primary generalized tonic-clonic seizures (GTCS), but efficacy is less well-characterized for myoclonic and absence seizures. A 29-year-old man with juvenile myoclonic epilepsy and medically refractory GTCS on a combination of levetiracetam and topiramate was started on lacosamide adjunctive therapy with the plan to replace topiramate. While his GTCS became controlled, he was witnessed to have confusional episodes, with waxing and waning responsiveness, lasting a few days, several times a month. After eight months of adjunctive lacosamide therapy, he was admitted to the epilepsy monitoring unit, where paroxysms of generalized spike-and-wave complexes, lasting for 30-90 minutes, were recorded, interrupted only by sleep. During these periods, he demonstrated psychomotor slowing and disorientation on examination. The absence status was successfully broken by lorazepam, and lacosamide was discontinued. The patient had no further confusional episodes at the most recent follow-up visit, four months after discharge.

KW - absence status

KW - antiepileptic medications

KW - idiopathic generalized epilepsy

KW - lacosamide

KW - seizure aggravation

UR - http://www.scopus.com/inward/record.url?scp=85063457846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063457846&partnerID=8YFLogxK

U2 - 10.1684/epd.2019.1032

DO - 10.1684/epd.2019.1032

M3 - Article

VL - 21

SP - 97

EP - 101

JO - Epileptic Disorders

JF - Epileptic Disorders

SN - 1294-9361

IS - 1

ER -