[Clinical experience of using zonisamide in structural focal epilepsy in children with cerebral palsy]

Area of Science:

• Pediatric Neurology
• Epileptology
• Cerebral Palsy Research

Background:

• Refractory epilepsy is a significant challenge in children with cerebral palsy (CP).
• Limited treatment options exist for managing seizures in this vulnerable population.
• Understanding the efficacy of add-on therapies is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the efficacy and safety of zonisamide as an adjunctive treatment for structural focal epilepsy in pediatric patients with CP.
• To determine the impact of zonisamide on seizure frequency and severity.
• To identify potential predictors of treatment response and adverse effects.

Main Methods:

• A cohort of 64 children (36 boys, 28 girls) with spastic CP and refractory focal epilepsy was studied.
• Patients received zonisamide at 6-8.8 mg/kg/day for at least 6 months.
• Efficacy was evaluated based on seizure reduction, considering CP type, seizure classification, and concomitant medications.

Main Results:

• A ≥50% seizure reduction was observed in 60.9% of children; 10.9% experienced complete seizure remission.
• Optimal response rates were noted for generalized seizures with focal onset (35.9%) and when combined with levetiracetam (35.9%).
• Mild to moderate adverse effects occurred in 26.5% of patients, leading to discontinuation in 7.8%.

Conclusions:

• Zonisamide is an effective add-on therapy for refractory structural focal epilepsy in children with CP.
• The treatment significantly reduces seizure frequency with a favorable safety profile.
• Zonisamide offers a viable therapeutic option for this complex patient group.