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Comparison of levetiracetam or zonicamide additional treatments in partial epilepsy diseases which karbamazepine monotherapy is not responded

Year 2018, Volume: 10 Issue: 4, 511 - 515, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.365144

Abstract

Background and Aims: Partial epilepsy is the most common
type of seizure and in some patients sufficient seizure control may not be
achieved despite monotherapy and even polytherapy. Our aim in this study was to
compare the efficacy and side effects of levetiracetam or zonisamide add-on
treatments in patients without seizure control with carbamazepine monotherapy.

Material and Method: Thirty-two patients aged 18-54 years
who were followed for at least 1 year by carbamazepine monotherapy were
included in the study. Zonisamide was added to 16 of these patients, and
levetiracetam was added to 16 of these patients. Patients were monitored for 3
months to be held at constant titration after the insertion therapy.

Results: The mean age of the group to which zonisamide was added was
33.4 ± 10.6 (7 males, 9 females) while the levetiracetam group had 35.7 ± 11.5
(8 males, 8 females). When 3-month follow-up period was evaluated in terms of
total number of seizures, there was no statistically significant difference
between the two groups in terms of efficacy and side effects (p = 0,377).







Conclusion: Levetiracetam or zonisamide can be used in patients
with partial seizures with similar side effects and fewer side effects in
patients with seizure control.

References

  • 1. Blume WT, Luders HO, Mizrahi E, Tassinari C, van Emde BW, Engel Jr. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia, 2001;42:1212-8. 2. Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984. Epilepsia, 1993;34:453-68. 3. Lavados J, Germain I, Morales A, Campero M, Lavados P. A descriptive study of epilepsy in the district of EL Salvador, Chile, 1984-1988. Acta Neurol Scand, 1992;91:718-29. 4. Joensen P. Prevalence, incidence and classification of epilepsy in Faroes. Acta Neurol Scand, 1986;74:150-5. 5. Steinlein O.K. Genes and mutations in idiopathic epilepsy. Am J Med Genet, 2001;106:136-45. 6. French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of new antiepileptic drugs, I: Treatment of new onset epilepsy: Report of TTA and OSS subcommittees of the American Academy of Neurology and the American Epilepsy Society. Epilepsia, 2004;45:401-9. 7. Epilepsi. Bora İ, Yeni S.N, Gürses C. Nobel Tıp Kitapevleri. 2008. 8. Baulac M, Leppik I.E. Efficacy and safety od adjunctive zonisamide therapy for refractory partial seizures. Epilepsy Res, 2007;75:75-83. 9. Seino M, Fıjitani B. Zonisamide, clinical efficacy and use in epilepsy. In: Levy R.H (Ed), Antiepileptic drugs. Lippincott, Williams, Wilkins, Philadelphia, 2002;5:885-91. 10. Thomas G, McCabe P.H. Clinical use of zonisamide in generalized seizure disorders. Epilepsia 2005;46 (suppl.7):2294. 11. Conry J.A, Ramsey R.E, Vossler D, Glauser T.A. Efficacy and safety of zonisamide as adjunctive therapy for primary generalized epilepsy. Epilepsia 2005;46(suppl.7):2350. 12. O’Rourke D, Flynn C, White M, Doherty C, Delanty N. Potential efficacy of zonisamide in refractory juvenile myoclonic epilepsy. Epilepsia 2005;46(suppl.6):301. 13. Welty T.E, Kuzniecky R, Faught E. Outcome of using new AED in juvenile myoclonic epilepsy. Neurology 2003;60(suppl.1):147. 14. Sackellares J.C, Ramsay R.E, Wilder B.J, Browne T.R, Shellenberger M.K. Randomized, controlled clinical trial of zonisamide as adjunctive treatment for refractory partial seizures. Epilepsia, 2004;45(6):610-7. 15. Ben-Menachem E, Falter U. and for the European Levetiracetam, Study Group, Efficacy and tolerability of levetiracetam, 3000 mg/d in patients with refractory partial seizures:a multicenter, double-blind, responder-selected study evaluating monotherapy. Epilepsia, 2000;41:1276–83. 16. Chadwick D.W, Marson A.G. zonisamide add-on for drug-resistant partial epilepsy. Cochrane Database Syst. Rev. 2005, Issue 4, CD001416. 17. Faught E, Ayala R, Montouris G, Leppik I. Randomize controlled trial of zonisamide for the treatment of refractory partial onset seizures. Neurology 2001;57:1774-9. 18. Harden C. Safety profile of levetiracetam. Epilepsia, 2001;42(4):36–9.

Karbamazepin monoterapisine yanıt alınamayan parsiyel epilepsi hastalarında levetiracetam veya zonisamid ek tedavilerinin karşılaştırılması

Year 2018, Volume: 10 Issue: 4, 511 - 515, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.365144

Abstract

Giriş ve Amaç: Parsiyel epilepsi en sık görülen nöbet tipi olup bazı hastalarda
monoterapi ve hatta politerapiye rağmen yeterli nöbet kontrolü
sağlanamayabilir. Bu çalışmadaki amacımız karbamazepin monoterapisi ile nöbet
kontrolü sağlanamamış hastalarda levetirasetam veya zonisamid ekleme
tedavilerinin etkinlik ve yan etki bakımından karşılaştırılması hedeflenmiştir.

Gereç ve Yöntem: 18-54 yaş arası, en az 1 yıldır karbamazepin
monoterapisi ile takip edilen 32 hasta çalışmaya alındı. Bu hastaların 16’sına
zonisamid, 16’sına levetirasetam eklendi. Hastalar ekleme tedavisi sonrası
sabit titrasyonda tutulacak şekilde 3 ay boyunca izlendi.

Bulgular: Zonisamid eklenen grubun yaş ortalaması 33,4±10,6 (7
erkek, 9 kadın
)
iken levetirasetam grubunda 35,7±11,5 (8 erkek, 8 kadın) idi. Toplam nöbet
sayıları bakımından 3 aylık izlem süresi değerlendirildiğinde her iki grup arasında
etkinlik ve yan etki bakımından istatistiksel olarak anlamlı fark
saptanmamıştır (p=0,377).







Sonuç: Parsiyel nöbetlerin ekleme tedavilerinde levetirasetam veya zonisamid
benzer oranda etkin olup nöbet kontrolü sağlanamayan hastalarda yan etki profilinin
de az olması nedeniyle kullanılabilir.

References

  • 1. Blume WT, Luders HO, Mizrahi E, Tassinari C, van Emde BW, Engel Jr. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Epilepsia, 2001;42:1212-8. 2. Hauser WA, Annegers JF, Kurland LT. Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984. Epilepsia, 1993;34:453-68. 3. Lavados J, Germain I, Morales A, Campero M, Lavados P. A descriptive study of epilepsy in the district of EL Salvador, Chile, 1984-1988. Acta Neurol Scand, 1992;91:718-29. 4. Joensen P. Prevalence, incidence and classification of epilepsy in Faroes. Acta Neurol Scand, 1986;74:150-5. 5. Steinlein O.K. Genes and mutations in idiopathic epilepsy. Am J Med Genet, 2001;106:136-45. 6. French JA, Kanner AM, Bautista J, et al. Efficacy and tolerability of new antiepileptic drugs, I: Treatment of new onset epilepsy: Report of TTA and OSS subcommittees of the American Academy of Neurology and the American Epilepsy Society. Epilepsia, 2004;45:401-9. 7. Epilepsi. Bora İ, Yeni S.N, Gürses C. Nobel Tıp Kitapevleri. 2008. 8. Baulac M, Leppik I.E. Efficacy and safety od adjunctive zonisamide therapy for refractory partial seizures. Epilepsy Res, 2007;75:75-83. 9. Seino M, Fıjitani B. Zonisamide, clinical efficacy and use in epilepsy. In: Levy R.H (Ed), Antiepileptic drugs. Lippincott, Williams, Wilkins, Philadelphia, 2002;5:885-91. 10. Thomas G, McCabe P.H. Clinical use of zonisamide in generalized seizure disorders. Epilepsia 2005;46 (suppl.7):2294. 11. Conry J.A, Ramsey R.E, Vossler D, Glauser T.A. Efficacy and safety of zonisamide as adjunctive therapy for primary generalized epilepsy. Epilepsia 2005;46(suppl.7):2350. 12. O’Rourke D, Flynn C, White M, Doherty C, Delanty N. Potential efficacy of zonisamide in refractory juvenile myoclonic epilepsy. Epilepsia 2005;46(suppl.6):301. 13. Welty T.E, Kuzniecky R, Faught E. Outcome of using new AED in juvenile myoclonic epilepsy. Neurology 2003;60(suppl.1):147. 14. Sackellares J.C, Ramsay R.E, Wilder B.J, Browne T.R, Shellenberger M.K. Randomized, controlled clinical trial of zonisamide as adjunctive treatment for refractory partial seizures. Epilepsia, 2004;45(6):610-7. 15. Ben-Menachem E, Falter U. and for the European Levetiracetam, Study Group, Efficacy and tolerability of levetiracetam, 3000 mg/d in patients with refractory partial seizures:a multicenter, double-blind, responder-selected study evaluating monotherapy. Epilepsia, 2000;41:1276–83. 16. Chadwick D.W, Marson A.G. zonisamide add-on for drug-resistant partial epilepsy. Cochrane Database Syst. Rev. 2005, Issue 4, CD001416. 17. Faught E, Ayala R, Montouris G, Leppik I. Randomize controlled trial of zonisamide for the treatment of refractory partial onset seizures. Neurology 2001;57:1774-9. 18. Harden C. Safety profile of levetiracetam. Epilepsia, 2001;42(4):36–9.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original article
Authors

Türkan Acar 0000-0003-2001-914X

Mehmet Fevzi Öztekin This is me

Neşe Öztekin This is me

Publication Date December 1, 2018
Published in Issue Year 2018 Volume: 10 Issue: 4

Cite

Vancouver Acar T, Öztekin MF, Öztekin N. Karbamazepin monoterapisine yanıt alınamayan parsiyel epilepsi hastalarında levetiracetam veya zonisamid ek tedavilerinin karşılaştırılması. omj. 2018;10(4):511-5.

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