title: Zonisamide monotherapy in newly diagnosed infantile spasms.
abstract: OBJECTIVE
  We determined the short-term efficacy of zonisamide (ZNS) monotherapy in newly diagnosed patients with infantile spasms (IS).
  
  
  METHODS
  Eleven hospitals participated in this open, prospective trial. ZNS 3-10 mg/kg/day was administered as the second-choice drug to 11 newly diagnosed patients with IS (cryptogenic 3, symptomatic 8) who failed to respond to high-dose vitamin B6.
  
  
  RESULTS
  Four infants with symptomatic IS had cessation of spasms and disappearance of the hypsarrhythmia. In these responders, the spasms ceased after a few days (1-5 days) of treatment at a dose of ZNS 4-5 mg/kg/day which produced plasma ZNS concentrations ranging from 5.2 to 16.3 microg/ml (mean 9.8 microg/ml). There were two relapses (50%) 4-6 weeks after cessation of seizures, however. Relapse was predicted by effects of ZNS on EEG; the 2 infants in whom an abnormal EEG persisted had relapses, whereas the 2 whose EEG normalized remained seizure-free (follow-up 20 and 26 months). No adverse reactions were noted.
  
  
  CONCLUSIONS
  ZNS may be effective in the initial treatment of selected patients with IS.
authors.affiliation: Department of Pediatrics, Osaka University Medical School, Suita, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Nagai
authors.forename: J
authors.initials: J
authors.lastname: Ono
authors.forename: K
authors.initials: K
authors.lastname: Imai
authors.forename: K
authors.initials: K
authors.lastname: Otani
authors.forename: T
authors.initials: T
authors.lastname: Tagawa
authors.forename: J
authors.initials: J
authors.lastname: Abe
authors.forename: M
authors.initials: M
authors.lastname: Shiomi
authors.forename: S
authors.initials: S
authors.lastname: Okada
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D006801:Humans; D007223:Infant; D007555:Isoxazoles / Q000627:therapeutic use*; D011446:Prospective Studies; D013036:Spasms, Infantile / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide; D000324:Adrenocorticotropic Hormone