The efficacy of topiramate in status epilepticus, experience from Thailand

ABSTRACT

Background: Oral topiramate is a broad-spectrum antiepileptic drug. There is limited documented data on its use in refractory convulsive and non-convulsive status epilepticus. Methods: A retrospective study of the clinical characteristics and responses of patients diagnosed as status epilepticus treated with topiramate at the Srinagarind Hospital, Khon Kaen University from 2001-2010. Results: There were 8 patients included in this study, 6 patients were convulsive status epilepticus and 2 patients were non-convulsive status epilepticus. The most common cause was stroke seen in 4 patients. Oral topiramate successfully controlled status epilepticus in 7 out of 8 patients with no serious adverse events. Of these 7 patients, status epilepticus was controlled after initial loading and re-loading of oral topiramate in 3 and 4 patients, respectively. In two patients with hepatitis, oral topiramate was successful after failure with benzodiazepine. The initial loading dose of topiramate in most cases was 400 mg with a maintenance dose of 100 mg/day. Conclusion: Oral topiramate has the potential to treat both convulsive and non-convulsive status epilepticus after failing the fi rst antiepileptic drug. Further study with larger number of patients is needed to confi rm this.