Use of sulthiame as add-on therapy in children with myoclonic atonic epilepsy: A study of 35 patients

•Add-on sulthiame led to a more than 50% seizure reduction in 21 of 35 patients with MAE.•Sulthiame reduced seizure frequency, mainly of myoclonic-atonic seizures and myoclonic seizures.•Efficacy against atypical absence seizures and generalized tonic-clonic was also shown.•In the group of responder...

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Published in:Epilepsy & behavior 2022-06, Vol.131 (Pt A), p.108702-108702, Article 108702
Main Authors: Caraballo, Roberto H., Reyes Valenzuela, Gabriela, Fortini, Sebastian, Espeche, Alberto, Gamboni, Beatriz, Bautista, Claudia, Cachia, Pedro, Semprino, Marco, Gallo, Adolfo, Galicchio, Santiago
Format: Article
Language:English
Subjects:
Drop attacks
Epilepsy
Myoclonic and atonic seizures
Sulthiame
Treatment-resistant
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Summary:•Add-on sulthiame led to a more than 50% seizure reduction in 21 of 35 patients with MAE.•Sulthiame reduced seizure frequency, mainly of myoclonic-atonic seizures and myoclonic seizures.•Efficacy against atypical absence seizures and generalized tonic-clonic was also shown.•In the group of responders, the EEG abnormalities also improved.•Sulthiame was generally well tolerated. The aim of this retrospective study was to evaluate efficacy and tolerability of sulthiame (STM) as add-on treatment in 35 patients with myoclonic atonic epilepsy (MAE) resistant to other antiseizure medications (ASMs) and/or non-pharmacological treatment. Patients were selected according to the diagnostic definition of MAE and were resistant to at least four previous to ASM, alone or in combination. Neurologic examinations, brain magnetic resonance imaging, and repeated prolonged electroencephalography (EEG) or video-EEG studies as well as neurometabolic studies were performed in all cases. Genetic studies were performed in 15 patients. Data on school achievements and/or neuropsychological evaluations were obtained over a mean follow-up of 30 months. Sulthiame was added in doses ranging from 10 to 30 mg/kg/day. Efficacy was assessed by comparing seizure frequency before and after initiating STM therapy. Twenty-one of 35 patients (60%) who received STM as add-on therapy had a greater than 50% seizure decrease after a mean follow-up of 30 months. Complete seizure freedom was achieved in two patients (5.8%). The remaining 14 patients (40%) had a 25–50% seizure reduction. Adverse effects, consisting of hyperpnea and dyspnea, decreased appetite, nausea, drowsiness, headache, and irritability, were observed in 11 (31.4%). The adverse effects were mild and transient in all cases. Discontinuation of STM was not necessary. Add-on STM led to a more than 50% seizure reduction in 21 of 35 patients with MAE with only mild or moderate adverse effects.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2022.108702