Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan; Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital Hamamatsu, Japan.
Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan.
Brain Dev. 2022 Jun;44(6):380-385. doi: 10.1016/j.braindev.2022.02.005. Epub 2022 Feb 28.
Childhood epilepsy with centrotemporal spikes (CECTS) is known as age-limited focal epilepsy syndrome in childhood. Lacosamide is a third-generation antiepileptic drug. This study aimed to evaluate the efficacy of lacosamide monotherapy for the treatment of CECTS.
We enrolled 18 patients (6 girls and 12 boys) who met the following criteria: 1) the age of onset of the seizures was between 3 and 13 years of age; 2) showing at least hemifacial and/or oropharyngeal seizures; 3) interictal discharges in central and/or middle temporal electrodes; 4) no intellectual disability; 5) treatment duration of lacosamide monotherapy over 6 months. We retrospectively collected and analyzed clinical data and treatment information. We evaluated the seizure occurrences during 0-3, 4-6, and 7-12 months from the treatment initiation and the last 6 months of the follow-up. We also evaluated the outcomes as seizure-free if the patients developed no seizures both over 6 months and 3 times of pretreatment mean seizure interval at the last follow-up.
Of the patients, 39%, 67% and 72% were seizure-free during 0-3, 4-6, and 7-12 months from treatment initiation, respectively. Finally, 83% of the patients achieved seizure freedom. Seizure freedom was achieved in 72% during the first 4 months of treatment. All patients continued lacosamide monotherapy during the study, although four patients showed transient fatigue or somnolence.
Lacosamide showed good efficacy for controlling seizures with fewer adverse effects, and therefore may be a good candidate as a first-line medication for the treatment of new-onset CECTS.
儿童中央颞区棘波灶癫痫（CECTS）是一种儿童期局灶性癫痫综合征。拉考沙胺是一种第三代抗癫痫药物。本研究旨在评估拉考沙胺单药治疗 CECTS 的疗效。
我们纳入了 18 名符合以下标准的患者（6 名女孩和 12 名男孩）：1）癫痫发作年龄在 3 至 13 岁之间；2）表现为至少半侧面部和/或口咽部发作；3）中央和/或中颞部有发作间期放电；4）无智力障碍；5）拉考沙胺单药治疗持续时间超过 6 个月。我们回顾性收集并分析了临床数据和治疗信息。我们评估了治疗开始后 0-3、4-6 和 7-12 个月的发作次数，以及随访的最后 6 个月的发作情况。如果患者在最后一次随访时既没有发作，且发作频率也达到治疗前 3 次平均发作间隔时间的 6 个月无发作，则评估结果为无发作。
治疗开始后 0-3、4-6 和 7-12 个月时，分别有 39%、67%和 72%的患者无发作。最终，83%的患者达到了无发作。在治疗的前 4 个月，有 72%的患者达到了无发作。所有患者在研究期间均继续接受拉考沙胺单药治疗，尽管有 4 名患者出现短暂性疲劳或嗜睡。
拉考沙胺治疗新诊断的 CECTS 具有良好的疗效，且不良反应较少，因此可能是治疗新诊断 CECTS 的一线药物。
