Abstracts

RATIONALE: Benign focal epilepsy of childhood (BFECh) or Rolandic epilepsy is a childhood syndrome presenting between 3-10 years of age with seizures present in 70-80% of affected patients. Treatment choices vary,with some patients electing not to treat. Ease of dosing, lack of blood test monitoring, and limited risk of severe side effects made us choose zonisamide (ZNS) to study as a once daily dosing form of treatment.
METHODS: Pediatric patients seen regularly by our clinic, who had recurrent abnormal routine awake and asleep EEG with triphasic peri-Rolandic spikes in drowsy and asleep states were screened to try ZNS as monotherapy for BFECh. There were 3 girls and 5 boys screened. Sulfa allergies eliminated 1 patient, 1 patient chose another anti-epileptic drug (AED), and 1 patient did not elect to start medication. Two patients failed 1 and 3 prior AEDs respectively. Three patients had no prior treatment with AEDs. The 5 patients who continued on the ZNS were monitored for 2-12 months (average 6.3 months). EEG studies were studied at 6 months into the study. Seizure diaries were recorded for the patients. All patients were started on 100 mg ZNS daily.
RESULTS: Tolerance of ZNS was seen in 4/5 patients. One patient had breakthrough seizures, and also developed anhydrosis requiring stopping the ZNS. None of the remaining patients on ZNS for 6 months had significant EEG improvement. Seizures were completely controlled in 4/5 patients. No significant appetite, sleep pattern, or behavioral problems occurred.
CONCLUSIONS: ZNS appears to be well tolerated and provided good seizure control in BFECh. Further study in this common childhood epilepsy is warranted.