Is sulthiame effective and tolerated as add‐on therapy for infants with epilepsy? A Cochrane Review summary with commentary

Abstract

BACKGROUND Epilepsy is one of the most common and disabling neurological disorders, affecting up to 65 million people worldwide. The main and recurrent symptoms of epilepsy are seizures, defined as paroxysmal events caused by atypical, involuntary rhythmic neuronal activity. Seizures are often unpredictable, causing distress in these patients, and therefore implicating cognitive, psychological, and social consequences. The principal therapeutic aim is to control the seizures and improve the quality of life of these patients. Antiseizure medication (ASM) is the first line of treatment for epilepsy. An appropriate ASM is selected on the basis of seizure type, epilepsy syndrome, or drug characteristics. If a single drug does not control the seizures, epilepsy is defined as drug-resistant epilepsy (DRE). DRE often requires polytherapy, combining ASM with different mechanisms of action. In this clinical scenario, use of sulthiame as add-on therapy seems to reduce seizure activity in people with DRE, as observed, for example, in children affected by Lennox– Gastaut syndrome. SULTHIAME ADD-ON THERAPY FOR EPILEPSY What is the aim of this Cochrane Review? The aim of this Cochrane Review was to assess the efficacy and tolerability of sulthiame as add-on therapy for people with epilepsy of any aetiology.