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Subcutaneous lacosamide for continuous focal seizures
  1. Helen Crispin1,
  2. Victoria Otway1 and
  3. Rhiannon Morris2
  1. 1 Palliative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2 Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Helen Crispin; helen.crispin{at}uhs.nhs.uk

Abstract

Management of continuous focal seizure activity provides a unique challenge in palliative medicine. In cases where the patient is conscious and would prefer to remain so, we need to balance seizure-control with the sedating side effects of anti-seizure medications. Here we present a case in which subcutaneous lacosamide was given as part of a multi-modal treatment regime for a patient with continuous focal seizure activity. Lacosamide is a relatively new anti-seizure medication, that, unlike some anticonvulsants, has few drug interactions, is relatively non-sedating, and has physicochemical properties compatible with administration by the subcutaneous route. This case report adds to the very limited existing literature on the administration of lacosamide by the subcutaneous route. We conclude that lacosamide potentially provides an attractive option to contribute to the individualised care of this group of patients, and it may also have a role in the management of neuropathic pain where the enteral route is not available.

  • Seizures
  • Drug administration
  • Neurological conditions
  • Pharmacology

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Footnotes

  • Contributors HKC and VO drafted the manuscript and RM provided manuscript neurology input and review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.