Our aim was to evaluate the EEG and clinical modifications induced by the new antiepileptic drug lacosamide (LCM) in patients with epilepsy. We evaluated 10 patients affected by focal pharmacoresistant epilepsy in which LCM (mean 250？mg/day) was added to the preexisting antiepileptic therapy, which was left unmodified. Morning waking EEG recording was performed before (t0) and at 6 months (t1) after starting LCM. At t0 and t1, patients were also administered questionnaires evaluating mood, anxiety, sleep, sleepiness, and fatigue (Beck Depression Inventory; State-Trait Anxiety Inventory Y1 and Y2; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Fatigue Severity Scale). We performed a quantitative analysis of EEG interictal abnormalities and background EEG power spectrum analysis. LCM as an add-on did not significantly affect anxiety, depression, sleepiness, sleep quality, and fatigue scales. Similarly, adding LCM to preexisting therapy did not modify significantly patient EEGs in terms of absolute power, relative power, mean frequency, and interictal abnormalities occurrence. In conclusion, in this small cohort of patients, we confirmed that LCM as an add-on does not affect subjective parameters which play a role, among others, in therapy tolerability, and our clinical impression was further supported by evaluation of EEG spectral analysis. 1. Introduction Epilepsy is one of the most common neurological disorders, affecting up to two percent of the population worldwide. Many patients show recurrent seizures despite treatment with appropriate antiepileptic drugs (AEDs’) [1, 2], and many experience AEDs side effects. In the last decades, new AEDs have been developed with the aim of balancing, as far as possible, significant efficacy with good tolerability. Among them, Lacosamide (LCM) has been recently authorized in Italy and worldwide as a new add-on AED for the treatment of pharmacoresistant focal epilepsy. Side effects of classical AEDs often involve cognitive functions, mood, and behavior to varying degrees, and this is the case also for newer AEDs (see, for instance, [3–5]). Unfortunately, a clear evaluation of these types of side effects in the single patient is often difficult because of the subjectivity of such complaints. This assessment is even harder in patients undergoing AED polytherapy. It has been proposed by several authors the usefulness of a quantitative analysis on EEG in patients undergoing treatment with drugs acting on the CNS (for a review, see for instance, [6]), in this setting, abnormalities of EEG power spectrum have
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