Lacosamide poisoning improved by hemodialysis

Abstract

Background: Lacosamide (LCM) is a third-generation antiepileptic drug that has been proven to be effective and safe, with few side-effects.

Case presentation: A woman aged in her 20s was transported to our hospital because of decreased consciousness. Many drugs, such as LCM (328 tablets) and perampanel hydrate (81 tablets), were found in her car. Her Glasgow Coma Scale score was 14. She was intubated and managed with mechanical ventilation, and she was treated with activated charcoal. Subsequently, hemodialysis (HD) was initiated due to the appearance of clonic convulsions. After 4 h of HD, no seizures were noted. The patient was weaned from the ventilator 18 h after admission and discharged on day 4. Her blood LCM level was 91.7 μg/mL on admission and 68.1 and 18.3 μg/ml before and after HD, respectively.

Conclusion: Hemodialysis was carried out in this severe case of LCM poisoning and was found to be effective.

Keywords: Blood concentration; hemodialysis; lacosamide; poisoning; seizure.