Limited efficacy of zonisamide in the treatment of refractory infantile spasms

Epilepsia Open
Shaun A HussainRaman Sankar

Abstract

A series of relatively small studies collectively suggest that zonisamide may be effective in the treatment of infantile spasms. Using a large single-center cohort of children with infantile spasms, we set out to evaluate the efficacy and safety of zonisamide. We retrospectively identified all patients with infantile spasms who were treated with zonisamide at our center. For each patient, we recorded dates of birth, infantile spasms onset, response (if any), and most recent follow-up. To quantify zonisamide exposure, we recorded daily dosage and patient weight at each sequential encounter so as to allow calculation of peak and weighted-average weight-based dosage. We identified 87 children who were treated with zonisamide, of whom 78 had previously been treated with hormonal therapy or vigabatrin. Peak and weighted-average zonisamide dosage were 7.1 (interquartile range 3.6, 10.2) and 5.4 (interquartile range 3.0, 8.9) mg/kg/day, respectively. Whereas five (6%) patients exhibited resolution of epileptic spasms, only two (2%) patients exhibited video-EEG confirmed resolution of both epileptic spasms and hypsarrhythmia (electroclinical response). Importantly, both electroclinical responders had not previously been treated with ho...Continue Reading

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Citations

Jun 25, 2020·Journal of Child Neurology·Zachary M GrinspanPhillip L Pearl
Apr 23, 2020·Expert Review of Neurotherapeutics·Nicola SpecchioPaolo Curatolo
Jul 24, 2021·Seizure : the Journal of the British Epilepsy Association·Prateek Kumar PandaLesa Dawman

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