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

Abstract

Objective. To evaluate the efficacy and safety of zonisamide as an add-on therapy in structural focal epilepsy in children with cerebral palsy (CP). Material and methods. Sixty-four patients (36 boys and 28 girls) with spastic CP and structural focal epilepsy with refractory seizures were followed up. Patients received zonisamide in a dose of 6—8.8 mg/kg/day for ≥6 months. Treatment efficacy was assessed by the reduction of seizures depending on CP form, type of epileptic seizures, combination of zonisamide with other drugs and adverse-effects. Results and conclusion. A reduction of seizures by ≥50% was identified in 60.9% of children, 10.9% showed a better recovery. The best efficacy (35.9%) was demonstrated in the treatment of generalized seizures with focal onset and in the combination with levetiracetam (35.9%). Adverse effects of mild to moderate severity were noted in 26.5% of children. The treatment was discontinued in 7.8%. Therefore, zonisamide is an effective treatment for refractory structural focal epilepsy in children with CP and comorbid pathology, which reduces the frequency of seizures without severe side-effects.