Affiliations: Neurology Division, Children's Hospital of Michigan,
University of Michigan, USA
Note:  Correspondence: Yasser Awaad, MD, M.Sc. Director, Pediatric
Neurology & Movement Disorders Program Clinical Associate Professor,
Pediatrics University of Michigan, 1331 Monroe Street, Dearborn, MI 48124, USA.
Tel.: +1 313 724 4861; Fax: +1 313 724 4840; E-mail: [email protected]
Abstract: This non-randomized, uncontrolled, single-center study was conducted
to evaluate the effects of zonisamide on intractable epilepsy in a primarily
pediatric population. Twelve patients ranging in age from 18 months to 23 years
were included in the study. All patients were diagnosed with intractable
seizures. Adjunctive therapy with zonisamide was initiated at 100~mg once a day
and increased, if needed, by 50–100 mg after one week to reach the maximal or
therapeutic dosage depending on patient age and weight. Follow-up occurred in
person or by phone at two weeks, one month, and every three months. All 12
patients responded favorably to adjunctive zonisamide. Five patients had
subclinical status interrupted and stopped as evidenced by clinical
examinations and electroencephalographic (EEG) findings. These patients also
became awake, alert, more attentive, and more interactive. An additional six
patients experienced clinical and EEG improvement in their seizure frequency,
duration, and severity. One patient with autonomic seizures showed EEG
improvement in seizure frequency, duration, and severity; however, seizure
prodrome control was not obtained. Adjunctive therapy with zonisamide benefited
all patients in this study, despite the variation in symptoms and etiology.
Zonisamide is thought to have multiple mechanisms of action, which may benefit
more patient types than antiepileptic drugs with a single mechanism of action.
Zonisamide was well tolerated by all patients.
Keywords: zonisamide, intractable seizures, children