Clinical Analysis of Lacosamide Monotherapy in the Treatment of Self-Limited Epilepsy with Centrotemporal Spikes

Objective: To evaluate the efficacy and safety of lacosamide (LCM) monotherapy in the treatment of self-limited epilepsy with centrotemporal spikes (SeLECTS).Methods: In this study, 89 children with SeLECTS who were treated with LCM monotherapy in the Children's Hospital Affiliated to Soochow University from June 2019 to June 2021 were included.Clinical seizures and spike wave index (SWI) on video EEG during slow-wave sleep were evaluated before and after treatment.The role of LCM monotherapy in improving SWI, controlling clinical seizures and improving cognition was analyzed, and corresponding adverse reactions were documented.Results: There were 52 males and 37 females in this group, with an average age of 7.6 ± 2.1 years.The total effective rate was 93.83% and at 18 months of treatment, the cumulative control rate was 85.19%, the retention rate was 91.01%and the effective rate in terms of EEG spike index was 72.92%, all of which showed a high rate; there was no statistically significant difference in intelligence quotient before and after treatment (P > 0.05).In addition, it was found in the study that the earlier the age of onset, the less obvious the improvement in SWI after LCM treatment; the lower the baseline seizure frequency, the more significant the improvement in SWI after LCM treatment.Conclusion: LCM monotherapy had curative effect and adverse reactions for SeLECTS, with no negative impact on cognition.These significant findings indicate that LCM is likely to become a widely prescribed ASM for the treatment of SeLECTS.Meanwhile, the onset age and baseline seizure frequency had certain value in judging prognosis and predicting curative effect.