title: Our clinical experience with zonisamide in resistant generalized epilepsy syndromes.
abstract: OBJECTIVE
  Zonisamide is licensed in the European Union for adjunctive therapy for partial epilepsy, but its efficacy in generalized epilepsy was less explored.
  
  
  METHODS
  This prospective observational study included 47 patients (mean age 29 years, range 3-50) with different resistant generalized epilepsy syndromes: idiopathic generalized syndromes (IGE) 15 patients, (juvenile myoclonic epilepsy four, absence epilepsy four, myoclonic absence two, unclassified IGE five), progressive myoclonic epilepsy type 1 (PME1) four, severe myoclonic epilepsy of infancy (SMEI) three, borderline SMEI three, Lennox-Gastaut syndrome/secondary generalized epileptic encephalopties 23 patients. All patients were followed up for at least six months. The mean dose given was 367 mg/day (range 100-600 mg/day), the patients received at least one and no more than two concomitant AE. Response was defined as more than 50% seizure reduction or seizure freedom.
  
  
  RESULTS
  The best effect was achieved in PME one, all the patients were responders. Myoclonic seizures were reduced 80%, none of the patients had generalized tonic clonic (GTC) seizures. In two of the four patients all other antiepileptics were tapered of (including piracetam), so they were GTC seizure and almost myoclonia free on zonisamide only. Responder rates were in GEFS +/- SME 62.5%, in resistant IGE 62.5%, and in epileptic encephalopathies 33.3% patients. Tolerance after initial efficacy developed in six patients. Adverse effects were mild: weight loss, somnolence and confusion were repeatedly reported. Three patients reported cognitive improvement.
  
  
  CONCLUSIONS
  Clinical benefit of a broad spectrum antiepileptic zonisamide extends across seizure types, ages and epilepsy syndromes. The efficacy in PME proved to be excellent.
authors.affiliation: National Institute of Neurosciences, Epilepsy Center, Budapest. kelemenanna@hotmail.com
authors.forename: Anna
authors.initials: A
authors.lastname: Kelemen
authors.forename: György
authors.initials: G
authors.lastname: Rásonyl
authors.forename: Magdolna
authors.initials: M
authors.lastname: Neuwirth
authors.forename: Gábor
authors.initials: G
authors.lastname: Barcs
authors.forename: Anna
authors.initials: A
authors.lastname: Szucs
authors.forename: Rita
authors.initials: R
authors.lastname: Jakus
authors.forename: Dániel
authors.initials: D
authors.lastname: Fabó
authors.forename: Vera
authors.initials: V
authors.lastname: Juhos
authors.forename: Beatrix
authors.initials: B
authors.lastname: Pálfy
authors.forename: Péter
authors.initials: P
authors.lastname: Halász
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003221:Confusion / Q000139:chemically induced; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced; D004351:Drug Resistance; D004831:Epilepsies, Myoclonic / Q000188:drug therapy; D004832:Epilepsy, Absence / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013036:Spasms, Infantile / Q000188:drug therapy; D016896:Treatment Outcome; D015431:Weight Loss; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide