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Research paper

Effects of sulthiame on seizure frequency and EEG in children with electrical status epilepticus during slow sleep

Pediatric cohort of ESES children treated with sulthiame (carbonic anhydrase inhibitor widely used in Europe). Reduction in seizure frequency and EEG spike-wave index in a meaningful subset, consistent with the ~53% response rate reported in the Kotagal 2017 pooled review. Generally well-tolerated.

Indexed context

Topçu Y, et al.

sulthiameesesdee-swascarbonic-anhydrase-inhibitor

Markdown path

content/research/papers/2021-topcu-sulthiame-eses-seizure-eeg.md

Findings

Pediatric cohort of ESES children treated with sulthiame (carbonic anhydrase inhibitor widely used in Europe). Reduction in seizure frequency and EEG spike-wave index in a meaningful subset, consistent with the ~53% response rate reported in the Kotagal 2017 pooled review. Generally well-tolerated.

Why it may matter for Levi

Option to raise with Levi's epileptologist if the March 2026 steroid pulse response is not durable. US availability is limited and would require special access or coordination. Supports the current treatment-rank placement of sulthiame as a second-tier non-steroid option.

Paper text

Topçu et al. (2021) — Sulthiame in pediatric ESES

Source

Why this paper is in the corpus

Pediatric cohort study of sulthiame (a carbonic anhydrase inhibitor widely used in Europe but uncommon in the United States) for ESES. Supports sulthiame as a reasonable fallback tier when steroids or benzodiazepines are not tolerated or have been exhausted.

Key findings

  • Pediatric cohort with ESES treated with sulthiame.
  • Reduction in seizure frequency and improvement in EEG spike-wave index in a meaningful subset.
  • Consistent with the Kotagal 2017 pooled review's ~53% sulthiame response rate.
  • Sulthiame is generally well-tolerated in pediatric populations.

Levi-relevant takeaways

  • Sulthiame remains an option to raise with Levi's epileptologist if the March 2026 steroid pulse response is not durable and a non-steroid maintenance therapy is needed.
  • US availability is limited; would require special access or coordination with a center that can source the drug.
  • Supports the existing treatment rank placement of sulthiame as a second-tier option behind steroids and high-dose benzodiazepines.

Citation note

Referenced as [18] in the 2026-04-21 user-supplied comprehensive DEE-SWAS / ESES / CSWS research report.