COGNITIVE ADVERSE EFFECTS OF LACOSAMIDE IN PATIENTS WITH LOCALIZATION RELATED EPILEPSY - A PROSPECTIVE OBSERVATIONAL STUDY

Newer antiepileptic drugs (AEDs) offer favourable safety profiles than the previously used AEDs. Despite the introduction of many AEDs, a large number of patients continue to suffer from uncontrolled partial-onset seizures which have considerable impact on a patient’s quality of life. Lacosamide (LCM) is a third generation AED approved for adjunctive use in partial-onset seizures. Patients with epilepsy frequently experience cognitive dysfunctions due to a variety of factors. Because AEDs are the major therapeutic modality for epilepsy, the adverse effects of AEDs on cognition are important. Objectives To assess the adverse effects of lacosamide on cognition among patients with localization related epilepsy to whom lacosamide is given as adjuvant therapy. 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.