Epilepsy Center and Department of Child Neurology, National Hospital Organization Nishiniigata Chuo Hospital, 1-14-1 Masago, Nishi-ku, Niigata 950-2085, Japan.
Epilepsy Center and Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki 856-8562, Japan.
Brain Dev. 2023 Sep;45(8):451-455. doi: 10.1016/j.braindev.2023.05.007. Epub 2023 Jun 10.
To report the long-term efficacy of adjunctive lacosamide therapy in patients with juvenile myoclonic epilepsy whose generalized tonic-clonic seizures were significantly reduced by treatment.
A retrospective study was conducted in patients who visited the Department of Child Neurology, National Hospital Organization Nishiniigata Chuo Hospital and the Department of Pediatrics, National Hospital Organization Nagasaki Medical Center. Among patients who had been diagnosed with juvenile myoclonic epilepsy, those who received lacosamide as adjunctive therapy for refractory generalized tonic-clonic seizures for at least 2 years from January 2017 to December 2022, and who achieved seizure freedom or >50% seizure reduction in tonic-clonic seizures were included. The medical records and neurophysiological data of the patients were reviewed retrospectively.
Four patients met the inclusion criteria. The mean age at the onset of epilepsy was 11.3 years (range 10-12), and the mean age of starting lacosamide was 17.5 years (range 16-21). All patients received two or more antiseizure medications prior to lacosamide. Three of four patients had seizure freedom for more than 2 years, and the one remaining patient had >50% seizure reduction for more than one year. Only one patient had recurrent myoclonic seizures after starting lacosamide. The mean lacosamide dose at the last visit was 425 mg/day (range 300-600).
Adjunctive lacosamide therapy might be a treatment option for juvenile myoclonic epilepsy with generalized tonic-clonic seizures, which are not responsive to standard antiseizure medications.
报告辅助拉科酰胺治疗对强直阵挛性发作明显减少的青少年肌阵挛癫痫患者的长期疗效。
本研究为回顾性研究，纳入 2017 年 1 月至 2022 年 12 月期间在国立医院组织越后中颈医院儿童神经内科和国立医院组织长崎医疗中心儿科就诊的被诊断为青少年肌阵挛癫痫且接受拉科酰胺辅助治疗至少 2 年的患者，这些患者的强直阵挛性发作为难治性，且拉科酰胺治疗使强直阵挛性发作达到无发作或发作减少≥50%。回顾性分析患者的病历和神经生理学数据。
符合纳入标准的患者有 4 例。癫痫发作的平均年龄为 11.3 岁（范围 10-12 岁），开始使用拉科酰胺的平均年龄为 17.5 岁（范围 16-21 岁）。所有患者在使用拉科酰胺之前均接受了两种或两种以上的抗癫痫药物治疗。4 例患者中有 3 例无发作持续 2 年以上，1 例无发作持续 1 年以上且发作减少≥50%。仅有 1 例患者在开始使用拉科酰胺后出现了肌阵挛性发作复发。最后一次就诊时拉科酰胺的平均剂量为 425 mg/天（范围 300-600 mg/天）。
对于标准抗癫痫药物治疗无效的强直阵挛性发作的青少年肌阵挛癫痫，辅助拉科酰胺治疗可能是一种治疗选择。
