Zonisamide efficacy as adjunctive therapy in children with refractory epilepsy
Parvaneh Karimzadeh1, Mahmoud Reza Ashrafi2, Mohammad Kazem Bakhshandeh Bali3
1Professor of Pediatric Neurology, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran ; Professor of Pediatric Neurology, Department of Pediatric Neurology, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Zonisamide effectively reduced seizure frequency in children with refractory epilepsy. This antiepileptic drug demonstrated short-term efficacy and safety, with manageable side effects in most pediatric patients.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epileptology
Background:
- Refractory epilepsy affects a significant portion of children, necessitating novel therapeutic options.
- Zonisamide is an antiepileptic drug with demonstrated efficacy in adult epilepsy management.
Purpose of the Study:
- To evaluate the effectiveness of Zonisamide as adjunctive therapy in pediatric patients with intractable partial seizures.
- To assess the safety and tolerability profile of Zonisamide in this pediatric population.
Main Methods:
- A prospective study involving 68 children diagnosed with refractory epilepsy.
- Patients received Zonisamide (2-12 mg/kg/day) as add-on therapy, with follow-ups every 3-4 weeks.
- Response was defined as a ≥50% reduction in seizure frequency or severity.
Main Results:
- 61 out of 68 patients completed the study.
- Zonisamide administration led to a significant decrease in daily seizure frequency at both one and six months.
- Mild, transient side effects were observed in 16.4% of patients, including decreased appetite and stuttering.
Conclusions:
- Zonisamide is a safe and effective short-term adjunctive treatment for children with refractory epilepsies.
- The drug offers a viable therapeutic option for pediatric patients who do not respond to conventional antiepileptic drugs.
Objective:
Approximately one third of epileptic children do not achieve complete seizure improvement. Zonisamide is a new antiepileptic drug which is effective as adjunctive therapy in treatment of intractable partial seizures. The purpose of the current study was to evaluate the effectiveness, safety, and tolerability of Zonisamide in epileptic children.
Materials & Methods:
From November 2011 until October 2012, 68 children who referred to Children's Medical Center and Mofid Children Hospital due to refractory epilepsy (failure of seizure control with the use of two or more anticonvulsant drugs) entered the study. The patients were treated with Zonisamide by dose of 2- 12 mg/kg daily in addition to the previous medication. We followed the children every three to four-weeks intervals based on daily frequency, severity and duration of seizures. During the follow-up equal and more than fifty percent reduction in seizure frequency or severity known as response to the drug.
Results:
In this study 68 patients were examined that 61 children reached the last stage.35 (57.4%) were male and 26 (42.6%) patients were female. After first and six months of Zonisamide administration daily seizure frequency decreased to 2.95±3.54 and 3.73±3.5 respectively. There was significant difference between seizure frequency in first and six month after Zonisamide toward initial attacks. After six months ZNS therapy a little side effects were created in 10 patients (16.4%) including stuttering(4.9%), decreased appetite (4.9%), hallucination (1.6%), dizziness(1.6%), blurred vision(1.6%) and suspiring(1.6%) as all of them eliminated later dosage reduction.
Conclusion:
This study confirms the short term efficacy and safety of Zonisamide in children with refractory epilepsies.
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