| Título: | Zonisamide Efficacy as Adjunctive Therapy in Children With Refractory Epilepsy |
| Autores: |
KARIMZADEH, Parvaneh; 1- Professor of Pediatric Neurology, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
2- Professor of Pediatric Neurology, Department of Pediatric Neurology, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ASHRAFI, Mahmoud Reza; 3- Professor of Pediatric Neurology, Tehran University of Medical Sciences, (TUMS), Tehran, Iran BAKHSHANDEH BALI, MohammadKazem; 4-Pediatric Research Center, Shahid Beheshti University of Medical Sciences, Tehran ,Iran NASEHI, Mohammad Mahdi; 5- Assistant Professor of Pediatrics, Pediatric Neurology Research Center, Shahid Beheshti TAHERI OTAGHSARA, Seyedeh Mohadeseh; 6- General Physician, Brain and Spinal Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, (TUMS), Tehran, Iran TAGHDIRI, Mohammad Mahdi; 7- Associated Professor of Child Neurology, Pediatric Neurology Research Center , Shahid Beheshi University of, Medical Science (SBMU), Tehran, Iran 8- Associated Professor of Child Neurology, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences,Tehran, Iran GHOFRANI, Mohammad; 1- Professor of Pediatric Neurology, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran 2- Professor of Pediatric Neurology, Department of Pediatric Neurology, Mofid Children Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran |
| Fecha: | 2013-04-27 |
| Publicador: | Iranian Journal of Child Neurology |
| Fuente: |
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| Tipo: |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion original articles |
| Tema: | Intractable Epilepsy; Antiepileptic drugs; Zonisamide |
| Descripción: | How to Cite This Article: Karimzadeh P, Ashrafi MR, Bakhshandeh Bali MK, Nasehi MM, Taheri Otaghsara SM, Taghdiri MM, Ghofrani M. ZonisamideEfficacy as Adjunctive Therapy in Children With Refractory Epilepsy. Iran J Child Neurol. 2013 Spring; 7(2):37-42.ObjectiveApproximately one third of epileptic children do not achieve complete seizure improvement. Zonisamide is a new antiepileptic drug which is effective as adjunctive therapy in treatment of intractable partial seizures.The purpose of the current study was to evaluate the effectiveness, safety, and tolerability of Zonisamide in epileptic children.Materials & MethodsFrom November 2011 until October 2012, 68 children who referred to Children’s Medical Center and Mofid Children Hospital due to refractory epilepsy (failure of seizure control with the use of two or more anticonvulsant drugs) entered the study. The patients were treated with Zonisamide by dose of 2- 12 mg/kg daily in addition to the previous medication. We followed the children every three to four-weeks intervals based on daily frequency, severity and duration of seizures. During the follow-up equal and more than fifty percent reduction in seizurefrequency or severity known as response to the drug.ResultsIn this study 68 patients were examined that 61 children reached the last stage.35 (57.4%) were male and 26 (42.6%) patients were female.After first and six months of Zonisamide administration daily seizure frequency decreased to 2.95±3.54 and 3.73±3.5 respectively. There was significant difference between seizure frequency in first and six month after Zonisamide toward initial attacks. After six months ZNS therapy a little side effects were created in 10 patients (16.4%) including stuttering(4.9%), decreased appetite (4.9%), hallucination (1.6%), dizziness(1.6%), blurred vision(1.6%) and suspiring(1.6%) as all of them eliminated later dosage reduction.ConclusionThis study confirms the short term efficacy and safety of Zonisamide in children with refractory epilepsies. References1. Michal V. Johnston. Seizure in childhood. In: Robert M. Kliegman, Richad E. Behrman. Nelson Text book of pediatrics.18th edition; Philadelphia:Saunders,2010,p 2457-70.2. Icardi J.Epilepsy in children .3th Ed. Lippincott Williams &Wilkins .edition .2004:38.3. Barbara Olson.Treatment of refractory epilepsy.Adv stumed 2005:Vol 5;470-473.4. Berto P. Quality of life in patients with epilepsy and impactof treatments. Pharmacoeconomics 2002;20:1039-59.5. Lepikk IE. Zonisamide: chemistry, mechanism of action,and pharmacokinetics. Seizure 2004;13S: S5-9.6. Sobieszek G, Borowicz KK, Kimber-Trojnar Z, Małek R, Piskorska B, Czuczwar SJ. Zonisamide: a new antiepileptic drug. Pol J Pharmacol 2003 Sep- Oct; 55(5): 683-9.7. Ohtahara, S. Zonisamide in the management of epilepsyJapanese experience. Epilepsy Res 2006;68 (Suppl. 2):25-33.8. Baulac M. Introduction to zonisamide. Epilepsy Res 2006;68(Suppl. 2):S3-S9.9. Hwang H, Kim KJ. New antiepileptic drugs in pediatric epilepsy. Brain Dev 2008;30(9):549-55.10. Kyoung Heo, Byung In Lee, Sang Do Yi, Yong Won Cho, Dong Jin Shin, Hong Ki Song, et al. Shortterm efficacy and safety of zonisamide as adjunctive treatment for refractory partial seizures: A multicenter open-label single-arm trial in Korean patients. Seizure 2012;21:188-193.11. Schulze-Bonhage A. Zonisamide in the treatment of epilepsy. Expert Opin Pharmacother 2010;11(1):115-26.12. Lee YJ, Kang HC, Seo JH, Lee JS, Kim HD. Efficacy and tolerability of adjunctive therapy with zonisamide in childhood intractable epilepsy. Brain Dev 2010;32(3):208-12.13. Marmaroua A, Pellockb JM. Zonisamide: Physician and patient experiences. Epilepsy Res 2005 Mar-Apr;64(1-2):63-9.14. Fallah R, Divesalar S, Babaei A. The efficacy and safety of zonisamide as an add-on drug in the treatment of lennox–gastaut syndrome. Iran J Child Neurol 2010 Nov;l4(3):45-50.15. Shah J, Shellenberger K, Canafax DM. Zonisamide: chemistry, biotransformation, and pharmacokinetics. Healthcare, Philadelphia (2002), pp. 873-879.16. Baulac M. Introduction to zonisamide. Epilepsy Res2006 Feb;68 (Suppl 2):S3-9. 17. Baulac M, Ilo E. Leppik. Efficacy and safety of adjunctive zonisamide therapy for refractory partial seizures. Epilepsy Research 2007;75:75-83. 18. Coppola G, Grosso S, Verrotti A, Parisi P, Luchetti A,Franzoni E, et al. Zonisamide in children and young adults with refractory epilepsy: An open label, multicenter Italian study. Epilepsy Research 2009;83:112-116.19. Tan HJ, Martland TR, Appleton RE, Kneen R. Effectiveness and tolerability of zonisamide in children with epilepsy: A retrospective review. Seizure 2010;19:31-35.20. Stephen LJ, Kelly K, Wilson EA, Parker P, Brodie MJ. A prospective audit of adjunctive zonisamide in an everyday clinical setting. Epilepsy Behav 2010 Apr;17(4):455-60.21. Catarino CB, Bartolini E, Bell GS, Yuen AWC, Duncan JS, Sander JW.The long-term retention of zonisamide in a large cohort of people with epilepsy at a tertiary referral centre. Epilepsy Research 2011;96:39-44.22. Loscher W, Schmidt D. Experimental and clinical evidence for loss of effect(tolerance) during prolonged treatment with antiepileptic drugs. Epilepsia 2006;47(8):1253-84.23. Eun SH, Kim HD, Eun BL, Lee IK, Chung HJ, Kim JS, et al. Comparative trial of low- and high-dose zonisamide as monotherapy for childhood epilepsy.Seizure 2011;20(7):558-63. |
| Idioma: | Inglés |
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