The indication for sulthiame, a carbonic anhydrase inhibitor, is benign childhood
epilepsy with centro temporal spikes (BECTS). Up to now there is no systematic study
of sulthiame in childhood epilepsy except BECTS.
We investigated the effect of sulthiame in childhood epilepsy in an open uncontrolled
study in predominantly new diagnosed epilepsy during a period of two years. 93 children
were enrolled, 52 boys, age 6.9±3.6 years; 41 girls, age 6.1±3.1 years with different
epileptic syndromes. The mean sulthiame dose was 5.59±2.32mg/kg BW in boys and 5.35±2.44mg/kg
BW in girls. Main side effects: hyperpnoe (7%), tiredness (3.2%), paresthesias (1.1%)
without necessity for withdrawal.
Therapy results: 74. 2% became seizure free; 12. 9% had an increase of seizures; 9.7% had no effect
on seizure frequency, 1.1% experienced a >50% seizure reduction or less severe seizure
intensity. Syndrome specific: BECTS (n=27): 96.3 seizure free, 3.7% unchanged; focal
motor (n=18): 68.4% seizure free, 15.8% no change, 10.5% increase; CPS (n=25): 64%
seizure free, 4% reduction >50%, 12% unchanged, 20% increase; grand mal (n=13): 76.9%
seizure free, 7.7%unchanged, 15.4%increase; Absence (n=1): seizure free; newborn seizure
(n=1): unchanged; myoclonic (n=8): 25% seizure free, 25% unchanged, 50% increase;
LGS (n=1): unchanged; CSWS (n=2): 100 seizure free. Effect of sulthiame on eeg: epileptic
discharges absent – unchanged – increase: BECTS 70.4%/14.8%/14.8%; focal motor: 68.4%/15.8%/5.3%;
CPS: 64%/16%/20%; myoclonic: 25%/25%/50%; absence: 100%; LGS: 0%/100%; newborn: 0%/100%;
CSWS: 100%.
Summary: Sulthiame is not only effective in BECTS, but also in other epilepsy syndromes in
childhood. In CPS, grand mal and focal motor seizures we achieved seizure control
in 2/3 of all children. Sulthiame was well tolerated, the side effects were to ignorable
in this study.