Buck Marcia L, Goodkin Howard P
Departments of Pharmacy Services, University of Virginia, Charlottesville, Virginia ; Departments of Pediatrics, University of Virginia, Charlottesville, Virginia.
J Pediatr Pharmacol Ther. 2012 Jul;17(3):211-9. doi: 10.5863/1551-6776-17.3.211.
Lacosamide was approved by the US Food and Drug Administration in 2008 for adjunctive therapy for focal onset seizures in patients 17 years of age and older. The efficacy of this agent in adults has led clinicians to consider lacosamide for children with refractory seizures.
The MEDLINE database (1950-June 2012) was searched for abstracts containing lacosamide as the key term. Additional references were obtained from the manufacturer and the bibliographies of the articles reviewed. All available English-language case reports and clinical trials were included in the evaluation.
Several case series studies have been published which support the use of lacosamide in children with refractory seizures. In the papers published to date, 30% to 50% of children experienced at least a 50% reduction in seizure frequency, similar to results obtained in clinical trials in adults. Children with focal onset seizures were most likely to benefit from treatment, while results in children with generalized seizures or multiple seizure types were mixed. Adverse effects in children were similar to those seen in adults, with dizziness, headache, and nausea occurring most frequently. Lack of efficacy has been the most common cause of discontinuation.
Lacosamide appears to be a useful adjunct therapy in children with refractory seizures. Clinical trials are under way that may provide more definitive information on the efficacy and safety of lacosamide in children and allow clinicians to determine the appropriate place of this antiseizure drug in pediatric epilepsy management.
拉科酰胺于2008年被美国食品药品监督管理局批准用于17岁及以上局灶性发作癫痫患者的辅助治疗。该药物在成人中的疗效促使临床医生考虑将拉科酰胺用于难治性癫痫患儿。
检索MEDLINE数据库（1950年至2012年6月）中以拉科酰胺为关键词的摘要。从制造商和所审查文章的参考文献中获取其他参考文献。所有可用的英文病例报告和临床试验都纳入评估。
已发表了几项病例系列研究，支持拉科酰胺用于难治性癫痫患儿。在迄今发表的论文中，30%至50%的患儿癫痫发作频率至少降低了50%，这与成人临床试验的结果相似。局灶性发作癫痫患儿最有可能从治疗中获益，而全身性发作或多种发作类型患儿的治疗结果则好坏参半。儿童的不良反应与成人相似，最常见的是头晕、头痛和恶心。缺乏疗效是停药的最常见原因。
拉科酰胺似乎是难治性癫痫患儿有用的辅助治疗药物。正在进行的临床试验可能会提供关于拉科酰胺在儿童中的疗效和安全性的更明确信息，并使临床医生能够确定这种抗癫痫药物在小儿癫痫治疗中的合适地位。
