TOPIRAMATE THERAPY OF CHILDREN WITH REFRACTOTY
PARTIAL-ONSET EPILEPSY
Wang
Zhi-ping, Wu Jie, Xu
Xie-ping, Bao Ke-rong
Shanghai
Xin Hua Hospital, Shanghai Second Medical University, Shanghai, China
Objective: To
evaluate the effectiveness of Topiramate (TPM) as add-on therapy in
treatment of intractable epileptic children. To make an assessment of
safety of TPM.
Methods: Patients
were considered for inclusion in this study if they had a history of
seizures under unsatisfactory control treated by conventional
anti-epileptic drug. There were eighteen boys and fourteen girls. The
initial TPM doses was 0.5-0.7mg/kg/day and increased by 0.5-1.0mg/kg/day
increments at 1-week intervals. Top dose was <8mg/kg/day. Each patient��s
vital signs, body weight, and general physical and neurologic states were
evaluated during every clinic visit.
Results: Average duration of TPM use was 7.8
months (range 3 to 17 months). Seven patients (21.88%) were seizure free
for 3 months and more than 50% reduction in seizure was found in 16
patients (50%). Inefficacy was 21.88% and 6.25% of the patients had their
seizure frequency increased during treatment. Three patients had transient
insomnia, one patient had bluntness and three patients had dizziness. The
adverse event developed during increment of TPM and disappeared gradually
within 2-4 weeks.
Conclusion: The safety profile of TPM in children
is similar to that seen in adults; adverse experienced are related to the
CNS, mild to moderate in severity, and frequently transient. TPM was well
tolerated on this small cohort.