Monotherapy for Childhood Epilepsies with Zonisamide

Abstract

Zonisamide was tried on 44 children, 18 girls and 26 boys, from 8 months to 15 years of age at the start of the trial. In 6 children the drug has been stopped because of side effects. The drug was introduced at a dose of 2-4 mg/kg/day and increased to 12 mg/kg/day unless a satisfactory response occurred at a Power dose. A 1OOyo control of seizures was achieved in 5 of 5 cases of idiopathic generalized epilepsies, in 7 of 8 cases of symptomatic generalized epilepsies, in one of one case of idiopathic partial epilepsies, and in 17 of 24 cases of symptomatic partial epilepsies. The main side effect was drowsiness, especially during the introduction.

Zonisamide

“…ZNS was started at 2 4 mg/ kg/day and increased until toxicity or satisfactory response occurred, with the maximal dose being 12 mg/ kg/day. In five cases of idiopathic generalized epilepsy, all achieved control, and in 7/8 cases of symptomatic generalized epilepsy, control was achieved (43).…”

“…In a study of children, 17 of 24 cases of symptomatic partial epilepsy had complete remission of seizures (43).…”

Tropical Review: Zonisamide in Pediatric Epilepsy: Review of the Japanese Experience

“…[34][35][36][37][38][39][40][42][43][44][45][46] For the purposes of this review, the responder rate was defined as the percentage of patients whose seizure frequency dropped by 50% or greater (compared with baseline) during zonisamide treatment. The remaining 2 trials40,41 did not present summary responder rates for partial-or generalized-onset seizures but, rather, responder rates for individual seizure subtypes.…”

Could Adult European Pharmacoresistant Epilepsy Patients Be Treated With Higher Doses of Zonisamide?

“…Recently, Velizarova et al 11 have also reported that refractory juvenile absence epilepsy can be controlled with ZNS, but nearly 30% (4 of 13) of their patients need high doses (>500 mg/d). In a monotherapy trial including 44 pediatric patients (25 with localization-related epilepsy and 13 with generalized epilepsy) reported by Kumagai et al, 12 ZNS was used in doses of up to 12 mg/kg per day (again considered high doses, the recommended dose in children being 8 mg/kg per day). Seizure freedom was achieved in 72% of subjects with localizationrelated epilepsy (18 of 25) and in 91% of those with generalized epilepsy (12 of 13).…”