Применение зонисамида (Зонеграна) в лечении эпилепсии у взрослых и детей (обзор зарубежной литературы и описание случая)

Несмотря на значительные успехи, достигнутые в эпилептологии, резистентные эпилепсии составляют примерно 30 % среди всех форм эпилепсии. Представлен обзор современной литературы, посвященной эффективности и безопасности нового антиэпилептического препарата зонисамид (Зонегран) в лечении эпилепсии, с акцентом на монотерапию. Описаны механизм действия, особенности фармакокинетики, эффективность и переносимость зонисамида при резистентной фокальной эпилепсии, а также при других типах приступов и формах эпилепсии. Рассматриваются показания к применению препарата. Описаны также более широкие возможности применения зонисамида: в лечении генерализованных приступов, при монотерапии, а также у детей и подростков. В настоящее время Зонегран зарегистрирован для применения у детей (начиная с 6 лет и старше) с фокальными приступами в дополнительной терапии. Авторы представляют собственное наблюдение высокой эффективности зонисамида в дополнительной терапии у ребенка 9 лет с криптогенной фокальной эпилепсией. Дебют эпилептических приступов в возрасте 5 месяцев. С момента начала заболевания ребенок получал множество антиэпилептических препаратов в разных комбинациях, без существенного эффекта. Зонисамид (Зонегран) был введен в терапию 4 мес назад в комбинации с препаратом вальпроевой кислоты (который ребенок получал на протяжении многих лет), и с момента выхода на полную дозу эпилептические приступы до настоящего времени отсутствуют. Следует отметить, что ремиссии длительностью 4 мес не было ни разу с момента начала заболевания. Также отмечалась нормализация сна. Переносимость терапии хорошая. Побочных эффектов не отмечалось.

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