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KMID : 1130620100060040189
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Journal of Clinical Neurology
2010 Volume.6 No. 4 p.189 ~ p.195
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Zonisamide Changes Unilateral Cortical Excitability in Focal Epilepsy Patients
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Joo Eun-Yeon
Kim Hye-Jung
Lim Yang-Hee
Ji Ki-Hwan
Hong Seung-Bong
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Abstract
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Background and Purpose: To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients.
Methods: Twenty-four drug-na?ve focal epilepsy patients (15 males; overall mean age 29.8 years) were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200 stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP), cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared.
Results: All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni’s correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres.
Conclusions: These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNS-induced changes in cortical excitability.
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KEYWORD
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transcranial magnetic stimulation, focal epilepsy, zonisamide, cortical excitability
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