ABSTRACT
Sulthiame, like acetazolamide (AZM), is a sulfonamide derivative, chemically related to the antibacterial agent sulfanilamide but devoid of antibacterial activity. It is an inhibitor of brain, and to a lesser extent erythrocyte, carbonic anhydrase, 10 to 20 times less potent than AZM. The majority of therapeutic trials of subbiarne date back to the 1960s and 1970s. It is difficult to reevaluate the results of these trials in light of present-day knowledge of clinical and electroencephalographic classification of epileptic syndromes. The average daily sulthiame dose and serum levels were high, giving rise to intolerable adverse effects and high dropout rate. The seizures of 83% of this heterogeneous sample were controlled or considerably improved on sulthiame used alone or in combination with other antiepileptic drugs. The effect of sulthiame on the electroencephalograms was impressive: in 51 of 58 patients, sharp waves disappeared soon after starting the drug, in some patients within 48 hours.
