Abstracts

RATIONALE: The purpose of this review is to evaluate the effectiveness of Zonisamide (ZNS) in intractable supplementary motor epilepsy (SME). SME is a particularly difficult epilepsy to diagnose and treat. Typically, these patients will have a seizure frequency of 5-10 per month, often nocturnal seizures, despite the use of multiple AEDs. This significantly affects the quality of life of both patients and families.
Zonisamide is a broad-spectrum AED with both common and unique mechanisms of action. This gives it broad clinical action against multiple seizure types of different anatomical origin. The type of epilepsy and its anatomical origin may help dictate what AED to select, given our many options. Zonisamide action on SME, a sub-type of frontal lobe epilepsy, is important both clinically and scientifically.
METHODS: We retrospectively reviewed five patients with documented SME where ZNS was added to current AED therapy. We evaluated clinical parameters, AED therapy, seizure frequency and side effects, both at baseline and periodically throughout the study.
RESULTS: Patients ranged in age from 26 to 51. Seizure frequency was high, 5 to 90 per month with a mean of 40, despite multiple AEDs used and extensive diagnostic and surgical workups. Marked reduction of seizure frequency was promptly seen and maintained (all greater than 16 weeks) with the addition of ZNS. Side effects were mild to moderate and diminished over time.
CONCLUSIONS: Despite the limited numbers in this retrospective review, the data indicates dramatic effectieness of Zonisamide in SME. Zonisamide use in this difficult to treat form of frontal lobe epilepsy should be prospectively studied and would provide significant clinical and scientific data about tailored AED treatment based on type, clinical type and AED mechanism of action.
Disclosure: Honoraria - Member of Speakers Bureau of Elan Pharmaceuticals.