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Comparative trial of low- and high-dose zonisamide as monotherapy for childhood epilepsy

Authors
 So-Hee Eun  ;  Heung Dong Kim  ;  Baik-Lin Eun  ;  In Kyu Lee  ;  Hee Jung Chung  ;  Joon Sik Kim  ;  Hoon-Chul Kang  ;  Young-Mock Lee  ;  Eun Sook Suh  ;  Dong Wook Kim  ;  Soyong Eom  ;  Joon Soo Lee  ;  Han Ku Moon 
Citation
 SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, Vol.20(7) : 558-563, 2011 
Journal Title
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
ISSN
 1059-1311 
Issue Date
2011
MeSH
Adolescent ; Anticonvulsants/administration & dosage* ; Anticonvulsants/therapeutic use ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Epilepsy/drug therapy* ; Female ; Humans ; Isoxazoles/administration & dosage* ; Isoxazoles/therapeutic use ; Male ; Treatment Outcome
Keywords
Zonisamide ; Child ; Epilepsy ; Cognition ; Behavior
Abstract
PURPOSE: To evaluate the effectiveness of zonisamide (ZNS) as monotherapy in children with newly diagnosed epilepsy.

METHODS: This randomized, multicenter trial included a 2-4-week titration and a 24-week maintenance phase after randomization to low-(3-4 mg/kg/day) or high-(6-8 mg/kg/day) dose groups as target maintenance dosages. The primary outcome measure was the seizure-free rate over 6 months, while a secondary measure was the change in cognition and behavior from screening to the end of the maintenance phase.

RESULTS: Out of 125 patients enrolled, 90 (49 low-dose and 41 high-dose) completed the study. Forty-one patients (63.1%) in the low-dose group and 34(57.6%) in the high-dose group achieved 6 months' freedom from seizures (p=0.66). After treatment, the picture arrangement subtest improved in the low-dose group (p=0.047) while the vocabulary subtest worsened in the high-dose group (p=0.020). Comparing between the two groups, the vocabulary subtest in the high-dose group was significantly worse than that in the low-dose group (p=0.002). Social competence, somatic complaints, depression/anxiety and delinquent and aggressive behavior in the low-dose group were significantly improved (p<0.05). Moreover, total social competence, somatic complaints, delinquent behavior, externalizing, and total behavior problems were significantly more improved in the low-dose group than the high-dose group (p<0.05).

CONCLUSIONS: ZNS is an effective monotherapy for newly diagnosed childhood epilepsy. Lower doses of ZNS have a similar efficacy and more beneficial neurocognitive effects compared to higher doses. When prescribing higher doses of ZNS, one must be aware of the possible manifestation of problems associated with language development, such as those affecting vocabulary acquisition.
Full Text
http://www.sciencedirect.com/science/article/pii/S1059131111001087
DOI
10.1016/j.seizure.2011.04.005
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Eom, So Yong(엄소용)
Lee, Young Mock(이영목) ORCID logo https://orcid.org/0000-0002-5838-249X
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93726
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