Efficacy of Zonisamide - Levetiracetam Comedication in Nine Adult Patients with Difficult to Treat Epilepsy and Intellectual Disability (A Case Series Report)

Abstract

Aim: Few studies have concerned anticonvulsive combination therapies in epilepsies resistant to established antiepileptic drugs in monotherapy. We sought to delineate the effects of zonisamidelevetiracetam comedication (ZNS+LEV) in adults with intellectual disabilities (ID). Material and Methods:Nine adult patients with drug resistant epilepsies and ID were treated in a routine outpatient setting with LEV or ZNS in combination with other anticonvulsants first and in a combination of both of them (ZNS+LEV) thereafter. Seizure frequency and behavioural effects were recorded in patients treated who approved to benefit from the combination of both substances but not when treated with only either of them. Results:The longitudinal follow up of individual cases of patients with difficult to treat epilepsies and intellectual disabilitiy (ID) suggests that the combination of ZNS and LEV may be an effective and well tolerated option, even if LEV or ZNS alone or in either other combinations had failed to reduce seizure frequency. Conclusions:These findings may not be generalized but request to perform further controlled studies on the efficacy and tolerability of the anticonvulsive therapy of ZNS in combination with LEV.