K. Iinuma et al., Long-term effects of zonisamide in the treatment of epilepsy in children with intellectual disability, J INTEL DIS, 42, 1998, pp. 68-73
Zonisamide is a new drug with broad-spectrum antiepileptic activity against
partial as well as generalized seizures. The purpose of the present study
was to compare the long-term efficacy of zonisamide in the treatment of epi
lepsy in children with intellectual disability (ID) with those with normal
intelligence (NI). One hundred and thirty children (74 ID, 56 NI) were incl
uded in the study. Fifteen of the subjects were eliminated from the study b
ecause of adverse effects or aggravation of seizures. The remaining 115 chi
ldren (66 ID, 49 NI) were followed up for more than one year. Twenty-eight
children (6 ID, 22 NI) were in zonisamide monotherapy. The mean numbers of
different antiepileptic drugs were 4.5 and 3 for the ID and NI groups, resp
ectively. The overall improvement rates, defined as a > 50% reduction in th
e number of seizures, were 41% (ID) and 67% (NI) (P < 0.01). Side-effects w
ere observed in 27% and 30% of subjects in the ID and NI groups, respective
ly. However, in the monotherapy group, side-effects were observed in 50% (I
D) and in 27% (NI). In conclusion, the effectiveness of zonisamide was weak
er in children with ID than those with NI. This is in agreement with the kn
own phenomenon that epileptic children with ID are likely have more intract
able seizures than those with NI.