Effect of sulthiame on EEG pathology, behavior and school performance in children with Rolandic epileptiform discharges.
BACKGROUND
Rolandic epileptiform discharges (RED) may be associated with behavioral difficulties and low school performance. The aim of this study was to assess whether sulthiame is effective in improving electroencephalogram (EEG) pathology, and whether these changes are paralleled by improved school performance and behavior.


METHODS
In this single-center study at a university hospital, 38 children with RED (27 boys, 11 girls; mean age, 6 years; range, 3-11 years), but no overt seizures, were included. Sixteen of them were treated with sulthiame (3-10 mg/kg). The observational period was 12 months. In both groups serial EEG was performed, and school performance and behavioral skills were assessed by parents and teachers.


RESULTS
Children treated with sulthiame showed marked improvement on EEG pathology when compared to the non-treated group (75% vs 44%; P= 0.149). Improvement of EEG pathology was significantly associated with better school performance and normalization of behavioral difficulties (P= 0.016). A significant positive correlation was established between sulthiame treatment and improved intellectual/school performance and behavior (P < 0.05). Side-effects (transient episodes of tachypnea) were rare (four children; 25%).


CONCLUSIONS
EEG pathology can be improved with sulthiame in children with RED. The EEG changes were associated with improved clinical outcome parameters. The present findings need to be confirmed in a larger randomized controlled trial.
Department of Paediatrics and Neonatology, Section Neuropaediatrics, University Children's Hospital of Saarland, Homburg, Germany.
Mohammed Ghiath
MG
Shamdeen
Wolfram
W
Jost
Martina
M
Frohnhöfer
Ludwig
L
Gortner
Sascha
S
Meyer
D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D002675:Child, Preschool; D004521:Educational Measurement; D004569:Electroencephalography / Q000187:drug effects*; D019305:Epilepsy, Rolandic / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D013843:Thiazines / Q000627:therapeutic use*; D016896:Treatment Outcome; D000096926:Benzenesulfonamides
D000927:Anticonvulsants; D013843:Thiazines; C084593:sulthiame; D000096926:Benzenesulfonamides