Department of Neurology, University of Marburg, Marburg, Germany.
Epilepsy Behav. 2010 Apr;17(4):549-51. doi: 10.1016/j.yebeh.2010.01.007. Epub 2010 Feb 18.
The anticonvulsant drug lacosamide selectively enhances slow inactivation of voltage-gated sodium channels and has been shown to be an effective add-on treatment for partial-onset seizures. Common adverse events (frequency 10%) of lacosamide doses up to 600 mg/day include nonspecific central nervous system effects (e.g., dizziness, ataxia, diplopia, and somnolence). There are no human data regarding the safety of very high dosages of lacosamide. We report the clinical course of a patient with bitemporal epilepsy who ingested 12 g of lacosamide, 56 g of gabapentin, 2g of topiramate, and 2.8 g of zonisamide during a suicide attempt. The patient was found comatose and experienced repeated generalized tonic-clonic seizures, aspiration with subsequent pneumonia, hypotension, and an increase in PR interval. Complete physical recovery occurred after several days of supportive treatment. We conclude that intoxication with lacosamide, in combination with overdoses of multiple AEDs, can be survived without sequelae, even after ingestion of 12 g lacosamide.
抗惊厥药物拉科酰胺选择性地增强电压门控钠离子通道的缓慢失活，已被证明是治疗部分发作性癫痫的有效附加治疗药物。拉科酰胺剂量高达 600mg/天的常见不良反应（频率为 10%）包括非特异性中枢神经系统效应（如头晕、共济失调、复视和嗜睡）。目前尚无关于拉科酰胺极高剂量安全性的人体数据。我们报告了一名颞叶癫痫患者的临床病程，该患者在试图自杀时摄入了 12g 拉科酰胺、56g 加巴喷丁、2g 托吡酯和 2.8g 左乙拉西坦。该患者被发现昏迷，并经历了反复全身性强直阵挛发作、随后的肺炎吸入、低血压和 PR 间隔增加。经过几天的支持治疗后，患者完全康复。我们得出结论，即使摄入 12g 拉科酰胺，与多种 AED 过量联合使用的拉科酰胺中毒也可以存活而没有后遗症。
