Effectiveness of Open-Label Zonisamide in Juvenile Myoclonic Epilepsy
Abstract number :
2.260
Submission category :
Year :
2001
Submission ID :
2022
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
P. Mullin, MD, Cedars-Sinai Medical Center, Los Angeles, CA; J.M. Stern, MD, UCLA Reed Neurological, Los Angeles, CA; A.V. Delgado-Escueta, MD, VA Medical Center UCLA, Los Angeles, CA; D. Eliashiv, MD, Cedars-Sinai Medical Center, Los Angeles, CA
RATIONALE: Zonisamide is a unique antiepilepsy drug (AED) approved for the treatment of partial seizures in adults with epilepsy. This compound has multiple mechanisms of anticonvulsant activity and reported efficacy against a variety of seizure types, including generalized tonic-clonic, absence, and myoclonic seizures. We report successful open-label use of zonisamide in poorly controlled juvenile myoclonic epilepsy (JME).
METHODS: Nine patients with clinically diagnosed, electroencephalogram-confirmed JME and poor seizure control began zonisamide therapy. Patients had been receiving an average of 2 medications, with either incomplete seizure control or unacceptable side effects on traditional AEDs. Zonisamide was titrated to tolerability and seizure control. Whenever possible, AED regimens were consolidated, and baseline medications were discontinued or reduced.
RESULTS: Eight of 9 patients remain on zonisamide (dosage range=200 to 500 mg/d) after a mean of 15 weeks (range=4 to 35). One patient with a known sulfa allergy discontinued zonisamide due to rash. All patients responded to zonisamide, having greater than 50% improvement in seizure control. Five of the 8 patients still taking zonisamide are presently seizure free. All patients were able to decrease the number of AEDs they had been taking prior to zonisamide (mean decrease=1 AED), with subsequent improvement or resolution of side effects, including tremor, alopecia, and weight gain. Two patients reported mild cognitive slowing but have chosen to remain on zonisamide.
CONCLUSIONS: Open-label use of zonisamide provided improved seizure control and was well tolerated in patients with JME. Further studies of zonisamide in the treatment of JME are warranted.
Disclosure: Consulting - Elan Pharmaceuticals; Honoraria - Elan Pharmaceuticals