Lacosamide efficacy in epileptic syndromeswith continuous spike and waves duringslow sleep (CSWS)

Summary. Background: Epileptic syndromes with continuous spikes-waves during sleep (CSWS) representa wide spectrum of epileptic disorders having CSWS as a common EEG-feature. Defined thera-peutic strategies are still lacking. We evaluated the efficacy of lacosamide add-on therapy onthe EEG, behavior, and cognition in children with CSWS.Material and methods: Eight children with CSWS refractory to other conventional antiepilepticdrugs were included in the study. A 24-h EEG recording was performed at 6-month-interval in allpatients. The spike-wave index (SWI) was obtained in each 24-h EEG recording. Neuropsychol-ogical data were obtained before lacosamide introduction and after a minimum of 12 monthsof therapy.Results: After a 6-month period of therapy, 75% of patients was defined as responder, 12.5% aspartial responder and another 12.5% as non-responder. In particular, 24-h EEG normalized in 3cases (37%). After a minimum of 12 months, 24-h EEG normalized in another patient while twopatients showed electroclinical relapses. A total of 62.5% of patients was therefore defined asresponder. Neuropsychological functions slightly improved in 25% of patients.Conclusion: Although further studies are needed to validate our observations, this study suggeststhat lacosamide add-on therapy may be safe and effective in children affected by CSWS.