Abstracts

Zonisamide is a new antiepileptic drug with multiple mechanisms of action that has been approved for adjunctive treatment of partial seizures in adults. The objective of this study was to evaluate the efficacy and tolerability of zonisamide monotherapy in a cohort of children with epilepsy. Retrospective review of charts at our institution from 2001-2004 identified 66 children with epilepsy on zonisamide monotherapy. Seizure count and side effects were maintained during therapy. There were 19 boys, 47 girls, ages 2.7-21.5 years (mean: 14.8 years). Average duration of therapy was 20.2 months (range 6 [ndash] 48 months). In 19 patients (28.7%) zonisamide was used as first line of therapy. The majority of patients had idiopathic generalized epilepsy (60%); 40% had partial onset epilepsies. Dose ranged from 2-13 mg/kg/day (mean 4.9 mg/kg/day). In the patients with idiopathic generalized epilepsy, 70% achieved [gt]50% reduction in seizure frequency, of whom 40% became seizure free. Amongst the group of children with partial epilepsy, 82.6% achieved [gt]50% reduction in seizure frequency, of whom 65.2% became seizure free. 14 patients (21.2%) developed side effects, including weight loss (9), sleepiness (3), dizziness (2). In 4 patients, zonisamide had to be discontinued (1 due to significant weight loss, and 3 due to poor seizure control). In 3 additional patients a second antiepileptic medication had to be added for better seizure control. Zonisamide proved to be effective and well tolerated as monotherapy in different types of pediatric epilepsy.