Department of Neurology, School of Medicine, University of Utah, Salt Lake City, UT 84132, United States.
Seizure. 2012 Apr;21(3):202-4. doi: 10.1016/j.seizure.2011.12.010. Epub 2012 Jan 26.
Juvenile myoclonic epilepsy is the most common form of idiopathic generalized epilepsy with onset at puberty or late teenage years. About 80-90% of patients with juvenile myoclonic epilepsy respond to appropriate antiepileptic treatment and achieve seizure freedom, and about 15% of patients become intractable. Valproic acid, levetiracetam, lamotrigine, topiramate and zonisamide are used as first line or adjunctive therapy of this disorder. Lacosamide is approved for adjunctive treatment of partial onset epilepsies. The role of lacosamide in treatment of idiopathic generalized epilepsy including juvenile myoclonic epilepsy is unknown. We present three patients with classic clinical and electrographic features of juvenile myoclonic epilepsy that were maintained on lacosamide (one on monotherapy and two as adjuvant therapy). There were no special pharmacodynamic actions causing exacerbation or worsening of myoclonic jerks or generalized seizures in these three patients. In conclusion, although, the data from our three patients' suggest that lacosamide may be effective in the treatment of juvenile myoclonic epilepsy, larger studies are needed to explore efficacy and role of lacosamide in the treatment of this disorder.
青少年肌阵挛癫痫是特发性全面性癫痫中最常见的一种，发病于青春期或青少年后期。约 80-90%的青少年肌阵挛癫痫患者对适当的抗癫痫治疗有反应并实现无癫痫发作，约 15%的患者为难治性癫痫。丙戊酸、左乙拉西坦、拉莫三嗪、托吡酯和唑尼沙胺被用作该疾病的一线或辅助治疗药物。拉科酰胺被批准用于辅助治疗部分发作性癫痫。拉科酰胺在特发性全面性癫痫（包括青少年肌阵挛癫痫）治疗中的作用尚不清楚。我们报告了 3 例具有典型临床和脑电图特征的青少年肌阵挛癫痫患者，他们均接受拉科酰胺治疗（1 例单药治疗，2 例辅助治疗）。这 3 例患者均未出现特殊的药效学作用，导致肌阵挛性抽搐或全身性癫痫发作加重或恶化。总之，尽管我们这 3 例患者的数据提示拉科酰胺可能对青少年肌阵挛癫痫的治疗有效，但仍需要更大规模的研究来探索拉科酰胺在该疾病治疗中的疗效和作用。
