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Effectiveness of zonisamide in childhood refractory epilepsy

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Abstract

Introduction

Zonisamide (ZNS) is a new generation antiepileptic drug (AED) used in refractory epilepsy. This study assessed the effectiveness and reliability of ZNS in childhood refractory epilepsy.

Method

Sixty-eight epilepsy patients who were followed up in the paediatric neurology clinic, between 2013 and 2019, and in whom add-on therapy ZNS had been added as their seizures had continued despite multiple drugs being used, were included in this retrospective study. Their demographic findings, seizure aetiology, pre-treatment and post-treatment electroencephalography findings, treatment responses and any side effects of the drugs given were assessed in these patients.

Results

There were 46 (67.6%) patients in the refractory generalized epilepsy (RGE) group using multiple AEDs and 22 (32.35%) patients in the refractory focal epilepsy (RFE) group. Of these patients, 12 (17.65%) were being followed up for idiopathic epilepsy and 8 (11.76%) were being followed up for epilepsy of unknown aetiology. Twenty-two (32.36%) patients were followed up for structural abnormality, 8 patients (11.77%) were followed up for genetic disease, 4 patients (5.88%) were followed up for infectious sequel, 14 patients (20.59%) were followed up for metabolic reasons. In the RGE group, a more than 50% reduction was found in the seizures of 26 (56.5%) patients, while the seizures of 7 (15.2%) patients were found to have terminated completely. In the RFE group, a more than 50% reduction was found in the seizures of 19 (86.4%) patients, while the seizures of 2 (9.1%) patients were found to have terminated completely. The termination or a more than 50% reduction in seizures in 4 of the 6 patients followed up for a diagnosis of tuberous sclerosis complex (TSC) was significant.

Conclusion

ZNS is an effective and reliable option as an add-on therapy in paediatric refractory epilepsy, especially in focal epilepsy. It can also be considered for treatment in TSC patients.

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Authors and Affiliations

  1. Department of Paediatrics, Mersin City Training and Research Hospital, Mersin, 33100, Turkey

    Mahmut Aslan

  2. Department of Paediatric Neurology, Faculty of Medicine, Inonu University, Malatya, Turkey

    Serdal Gungor

Authors
  1. Mahmut Aslan
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  2. Serdal Gungor
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Correspondence to Mahmut Aslan.

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Ethical approval

Approval numbered 2019/10–6 was given by the ethical board for our study from the İnönü University Scientific Research and Publication Ethics Board.

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Informed consent was obtained for the patient information.

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Aslan, M., Gungor, S. Effectiveness of zonisamide in childhood refractory epilepsy. Childs Nerv Syst 38, 971–976 (2022). https://doi.org/10.1007/s00381-022-05458-y

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