Efficacy of intravenous lacosamide in refractory nonconvulsive status epilepticus and simple partial status epilepticus

Nonconvulsive status epilepticus (NCSE) and epilepsia partialis continua (EPC) are common epileptic conditions for which straightforward recommendations based on controlled randomized trials for treatment in therapy refractory courses are lacking. In a large retrospective study on drug efficacy in status epilepticus (SE) we identified the patients treated in our department by searching for the term "status epilepticus" in the electronic archive of medical reports of our clinic. Here we present the subset of data concerning the patients treated with lacosamide (LCM). Ten episodes of SE in nine patients could be analyzed. To control for age dependency of results at discharge we calculated a Spearman correlation coefficient with age as independent variable and return to baseline Modified Rankin Score (mRS) at discharge=1, worsening of condition at discharge (i.e. new neurological deficit or worsening of mRS)=2 and death in hospital=3 as dependent variables. LCM was given in dosages of 50-100mg. It was not earlier administered than as fourth drug. Nevertheless it seemed to be effective for termination of status epilepticus in 20% of the episodes. But the outcome at discharge seemed considerably to depend on age of patients (r=0.94, explaining 89% of variance).