Use of zonisamide in children with cerebral palsy and epilepsy: literature review and own data

Cerebral palsy (CP) is often combined with epilepsy and epileptiform activity on the electroencephalogram. Uncontrolled epileptic seizures in CP limit rehabilitation opportunities, which aggravates motor and cognitive deficits. The main epileptic syndromes in children with CP are focal epilepsy with structural changes in the brain and benign epileptiform patterns of childhood on the electroencephalogram and structural focal epilepsy; the main types of seizures are focal motor, bilateral tonic-clonic, febrile-provoked seizures may also be observed. In CP, seizures often have a status course, can last more than 30 minutes and are stopped only in the intensive care unit. One patient may have several types of seizures, including epileptic status. Even in the absence of seizures, changes in the electroencephalogram are detected both in the form of regional epileptiform activity, often in the structure of regional prolonged slowing, and in the form of benign epileptiform patterns of childhood. Valproates, topiramate, levetiracetam, zonisamide, lamotrigine, ethosuximide, perampanel, vigabatrin, sultiame, rufinamide are recommended in the treatment of epilepsy in CP. We present a literature review and analysis of our own data on the use of zonisamide in patients with epilepsy and CP aged 6 to 17 years.