Revista de neurologia · 2015
[Reversible neuropsychological deterioration associated to zonisamide in a paediatric patient with tuberous sclerosis].
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Fournier-Del Castillo M Concepción, Melero-Llorente Javier, Blanco-Beregana Miriam, Robles-Bermejo Fernando, Budke Marcelo, Garcia-Fernandez Marta, Garcia-Penas Juan José, Perez-Jimenez M Ángeles
Аннотация
AIM: 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.
CASE REPORT: 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.
CASE REPORT: 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.
Предметные рубрики MeSH
AcetamidesAnticonvulsantsBenzodiazepinesChildClobazamCognition DisordersDibenzazepinesDrug SubstitutionDrug Therapy, CombinationEpilepsies, PartialFrontal LobeHumansIsoxazolesLacosamideLanguage DisordersLearning DisabilitiesMaleMemory DisordersNeuroimagingNitrilesPyridonesTuberous SclerosisZonisamide