Lacosamide on background eeg activity in brain tumor‐related epilepsy patients: A case series study

Abstract

ObjectiveTherapeutic doses of antiepileptic drugs (AEDs) may alter EEG background activity, which is considered an index of the functional state of the brain. Quantitative analysis (qEEG) of EEG background activity is a valid instrument to assess the effects of many centrally active drugs on the central nervous system, including AEDs. Lacosamide (LCM) is a new AED that could be a valid therapeutic choice in patients with brain tumor‐related epilepsy (BTRE).MethodsWe used qEEG to analyze the possible effect of LCM as an add‐on, on background EEG activity after 4 months in patients with BTRE.ResultsWe consecutively recruited sixteen patients with BTRE: Five dropped out for disease progression, five for scarce compliance, and six completed the study. For these reasons qEEG was performed at first visit and after 4 months only in six patients. For all frequency bands, LCM revealed no changes of mean relative power during rest with eyes closed, hyperpnoea (HP), and mental arithmetic task (MA); significant increment was found only in the theta mean relative power during opening and closing eyes (BR). After four months of therapy with LCM, one patient was seizure free, four had a seizure reduction ≥50%, and one showed a worsening in seizure frequency <50%.ConclusionDespite the limitation of a small series, these findings suggest that LCM seems to have only a mild interference on EEG background activity and confirm that LCM has a good efficacy on seizure control in patients with BTRE. This is the first study that evaluates the effect of LCM on background EEG activity, using qEEG in BTRE patients. Future research in this area could include prospective studies with qEEG for a longer follow‐up period to assess the impact of AEDs on brain functions in this particular fragile patient population.

Prognostic interictal electroencephalographic biomarkers and models to assess antiseizure medication efficacy for clinical practice: A scoping review

“…With regard to IED, we could further consider support for this biomarker as a predictor of treatment failure, coming from different types of evidence, such as four studies 30,88–90 that classified an EEG as abnormal defined only by the presence of IED, three studies 63,81,91 investigating the presence of IED, and particularly six studies 53,54,62,78,79,92 investigating different statistics of IED counts in different types of ASMs. However, not all ASMs have been investigated, and interpretability of results was also reduced by 42 studies that investigated initiation of adjunct ASM to mono‐ or polytherapy, particularly 20 underpowered studies 44,50,55,57,60,62,69,71–73,80,87,88,92–98 investigating polytherapy combinations.…”

“…three studies 63,81,91 investigating the presence of IED, and particularly six studies 53,54,62,78,79,92 investigating different statistics of IED counts in different types of ASMs. However, not all ASMs have been investigated, and interpretability of results was also reduced by 42 studies that investigated initiation of adjunct ASM to mono-or polytherapy, particularly 20 underpowered studies 44,50,55,57,60,62,69,[71][72][73]80,87,88,[92][93][94][95][96][97][98] investigating polytherapy combinations.…”

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

“…[25][26][27][28][29] Less data are present in literature about the third-generation ASMs, with few reports about lacosamide (LCM) or eslicarbazepine (ESL). [30][31][32] Cognitive consequences of ASMs are frequent in both adults and children, since treatment with ASMs, although controlling seizure, can impair learning abilities, cause sleepiness, and reduce the processing speed and brain capacities due to sedation and depression of brain activity. In keeping with this evidence, several ASMs (in particular, first-generation ASMs-phenytoin, carbamazepine, phenobarbitol) reduce fast EEG rhythms by increasing theta activity and reducing alfa and beta qEEG rhythms.…”

“…25-29 Less data are present in literature about the third-generation ASMs, with few reports about lacosamide (LCM) or eslicarbazepine (ESL). 30-32…”

The high incidence and risk factors of levetiracetam and lacosamide-related skin rashes in glioma patients

“…Previous reports have shown that LEV and LCM have fewer side effects than conventional ASDs. [5,6,13,14] A previous systematic review that investigated the e cacy of LEV for BTRE, including 21 articles (3 randomized controlled trials, 7 prospective observational studies, and 11 retrospective observational studies), did not examine the incidence of ASD-related eruptions.…”