title: [Reversible neuropsychological deterioration associated to zonisamide in a paediatric patient with tuberous sclerosis].
abstract: OBJECTIVE
  To document reversible cognitive deterioration associated to high doses of zonisamide, using the Reliable Change Index to control practice effects derived from repetitive neuropsychological assessments.
  
  
  METHODS
  A 11 year-old boy with tuberous sclerosis complex and left frontal refractory epilepsy, evaluated within a paediatric epilepsy surgery program. The epileptogenic zone was found to be related with a tuber situated on the left inferior frontal gyrus. The effects of high doses of zonisamide simulate a disturbance of eloquent cortex within the epileptogenic zone and the impact of uncontrolled seizures on cognitive functioning over the language-dominant hemisphere. Drug withdrawal significantly improved total intelligence index, verbal comprehension intellectual index and specific language-sustained cognitive abilities, beyond practice effects.
  
  
  CONCLUSIONS
  The differentiation between cognitive effects of drugs and functional deficits resulting from eloquent cortex involvement within the epileptogenic zone can be of crucial importance in the decision-making process for epilepsy surgery.
authors.affiliation: Hospital Infantil Universitario Nino Jesus, 28009 Madrid, Espana.
authors.forename: M Concepción
authors.initials: MC
authors.lastname: Fournier-Del Castillo
authors.forename: Javier
authors.initials: J
authors.lastname: Melero-Llorente
authors.forename: Miriam
authors.initials: M
authors.lastname: Blanco-Beregana
authors.forename: Fernando
authors.initials: F
authors.lastname: Robles-Bermejo
authors.forename: Marcelo
authors.initials: M
authors.lastname: Budke
authors.forename: Marta
authors.initials: M
authors.lastname: Garcia-Fernandez
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Garcia-Penas
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: Perez-Jimenez
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002648:Child; D000078306:Clobazam; D003072:Cognition Disorders / Q000139:chemically induced*; D003984:Dibenzazepines / Q000627:therapeutic use; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects* / Q000627:therapeutic use; D000078334:Lacosamide; D007806:Language Disorders / Q000139:chemically induced*; D007859:Learning Disabilities / Q000139:chemically induced*; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced; D059906:Neuroimaging; D009570:Nitriles; D011728:Pyridones / Q000627:therapeutic use; D014402:Tuberous Sclerosis / Q000150:complications*; D000078305:Zonisamide
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D003984:Dibenzazepines; D007555:Isoxazoles; D009570:Nitriles; D011728:Pyridones; D001569:Benzodiazepines; D000078306:Clobazam; D000078305:Zonisamide; D000078334:Lacosamide; C551441:perampanel; C571001:eslicarbazepine