COGNITIVE ADVERSE EFFECTS OF LACOSAMIDE IN PATIENTS WITH LOCALIZATION RELATED EPILEPSY - A PROSPECTIVE OBSERVATIONAL STUDY
More than 30% of epilepsy patients remain refractory to pharmacotherapy. Combined administration of AEDs or the application of novel AEDs is a therapeutic option especially when surgical treatment cannot be offered. The newer AEDs offer new mechanisms of action and more favourable safety profiles than the older AEDs. Lacosamide (LCM) is one of the third generation AEDs approved for adjunctive use in partial-onset seizures. Patients with epilepsy frequently experience cognitive dysfunctions. Because antiepileptic drugs (AEDs) are the major therapeutic modality for epilepsy, the adverse effects of AEDs on cognition are important. Objectives: This study was conducted to obtain reliable data on the cognitive adverse effects of lacosamide in Indian population. METHODOLOGY : An open labelled prospective observational study in 22 patients who suffered from localization related epilepsy. Results: Average Initial seizure frequency per month was 3.56 (SD 2.58) and median frequency 2.5 seizures per month. Range being 1-8 per month. At the final followup at 6months, only 2 persons experienced seizure and that too only single episodes. The difference in frequency is statistically significant (Wilcoxon Signed Ranks TestP <0.001). All the pre and post lacosamide cognition scores showed statistically significant positive correlation in this study. Conclusion: Excellent seizure control is observed in patients with refractory localization related epilepsy treated with lacosamide. Also, lacosamide has no serious adverse effects or drug interactions. In this study, it is observed that unlike many AEDs, lacosamide contributed to significant improvement in cognition and can improve the quality of life in such patients.