ObjectiveTo observe and analyze the efficacy and adverse reactions of Lacosamide (LCM) in the treatment of refractory epilepsy in children and adolescents. MethodsA retrospective cohort study was conducted on 85 patients with refractory epilepsy, with 50 males and 35 females, aged 0.5 ~ 15 years with an average age of (6.90±3.61) years, who were treated in the Department of Neurology of Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, from January 2020 to March 2023. A self-controlled study was conducted by oral LCM add on treatment, and follow-up was performed to compare and observe the efficacy as well as the adverse reactions before and after the use of LCM. ResultsBy self-control, after 12 months of follow-up after addition of LCM treatment, compared with baseline, the frequency of seizures decreased after 3, 6 and 12 months of treatment, the differences were statistically significant (P<0.05), and the effective rate of analysis after 3, 6 and 12 months of addition of treatment were 36.47%, 42.35% and 41.18%, respectively. There were 22 cases without seizure after 12 months of LCM treatment, and the seizure-free rate was 25.88%. Enrolled patients used a variety of antiseizure medications at baseline, and the three drugs used by the most patients were sodium valproate in 54 cases (63.53%), levetiracetam in 41 cases (48.24%) and oxcarbazepine in 24 cases (28.24%) respectively. After addition of LCM, a total of 10 cases experienced adverse reactions, such as dizziness, headache, nausea, etc. The incidence of adverse reactions was 11.76%. The retention rate at 12 months after adding LCM was 63.5%. ConclusionsThe addition of LCM in the treatment of refractory epilepsy in children and adolescents can effectively improve the frequency of seizures, with fewer adverse reactions and higher retention rates.