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Zonisamide - induced urinary lithiasis in patients with intractable epilepsy
M Kubota1, M Nishi-Nagase, Y Sakakihara
1Department of Pediatrics, University of Tokyo, Japan. kubota@ped.h.u-tokyo.ac.jp
Brain & Development
|June 6, 2000
Summary
Zonisamide (ZNS) treatment for epilepsy can lead to urinary lithiasis, including stones and bladder sludge. Monitoring urine parameters is recommended during ZNS therapy, especially for high-risk patients.
Area of Science:
- Nephrology
- Neurology
- Pharmacology
Background:
- Zonisamide (ZNS) is an antiepileptic drug used for intractable epilepsy.
- Urinary lithiasis is a potential adverse effect of certain medications.
Observation:
- Three patients with intractable epilepsy developed urinary lithiasis during ZNS treatment.
- Symptoms ranged from abdominal pain and hydronephrosis to asymptomatic bladder sludge (calcium phosphate and calcium oxalate).
- Urinalysis revealed alkaline urine and hypercalciuria in all affected patients.
Findings:
- Discontinuation of ZNS and supportive therapy resolved the urinary lithiasis.
- The cases highlight a link between ZNS use and the formation of urinary calculi.
- Alkaline urine and hypercalciuria were consistent findings in patients developing lithiasis.
Implications:
- Routine monitoring of urine pH, sediments, and daily output is crucial for patients on ZNS.
- This monitoring is particularly important for bedridden patients or those on multiple antiepileptic drugs.
- Early detection and intervention can prevent complications associated with ZNS-induced urinary lithiasis.