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. 2021 Jan;42(1):183-191.
doi: 10.1007/s10072-020-04526-y. Epub 2020 Jun 26.

Sulthiame add-on treatment in children with epileptic encephalopathy with status epilepticus: an efficacy analysis in etiologic subgroups

Seda Kanmaz  1 , Erdem Simsek  2 , Hepsen Mine Serin  2 , Sanem Yilmaz  2 , Gul Aktan  2 , Hasan Tekgul  2 , Sarenur Gokben  2
Affiliations

Sulthiame add-on treatment in children with epileptic encephalopathy with status epilepticus: an efficacy analysis in etiologic subgroups

Seda Kanmaz et al. Neurol Sci. 2021 Jan.

Abstract

Purpose: Sulthiame (STM) has been recommended as an effective antiepileptic drug (AED) in children with epileptic encephalopathy with status epilepticus in sleep (ESES). The aim of this study is to evaluate the efficacy of STM add-on treatment in children with pattern of ESES with respect to the etiologic subgroup.

Methods: Twenty-nine children with ESES pattern with three different etiologic subgroups (epileptic syndromes: 14, structural/infectious: 9, unknown: 6) who were given STM as add-on treatment were included into the study. The efficacy of STM was evaluated in terms of seizure control, electroencephalography (EEG) findings, need of the new AEDs after add-on STM, and behavioral and cognitive improvement.

Results: The range of the follow-up duration after add-on STM treatment was between 5 and 51 months. At the end of 1 year of STM treatment, the most successful electrophysiologic improvement was identified in the well-defined epileptic syndrome group; epileptic syndrome, 71.4% (10/14); structural/infectious, 33.3% (3/9); and unknown, 0% (0/6). Patients who had complete response or persistent ESES pattern at the 3rd month were still in the same condition at the 6th and 12th months. However, the ESES pattern reappeared in 35.2% of the patients who had partial electrophysiological improvement at the 3rd month. In the epilepsy syndrome group, eight out of ten patients who had either complete or partial EEG response after 1 year of STM treatment displayed behavioral and cognitive improvement.

Conclusion: Sulthiame might be a valid add-on treatment of ESES especially in children with epilepsy syndromes.

Keywords: ESES; Epilepsy syndromes; Sulthiame.

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