Clinical Study of Effectiveness Topiramate in Children with Intractable Epilepsy

ABSTRACT

PURPOSE: Topiramate(TPM) is a new anticonvulsant with multiple action mechanisms which should theoretically represent a wide therapeutic spectrum. However, there is still little clinical experience of its use in Asian children with epilepsy. METHODS: The patients were total 96 children who were treated with more than 2 anticonvulsants but poorly controlled seizure activity. TPM was given as add-on therapy and evaluated the efficacy and adverse events prospectively. This study consisted of 8 weeks of baseline phase, 10- 16 weeks titration phase, and 8 weeks of stabilization phase. Clinical efficacy was classified into 4 groups disappearance, marked improvement, improvement, no improvement. RESULTS: When TPM was prescribed, a response of >50% reductions in seizure attacks was seen in 90.6% of cases(95.5% of partial type epilepsy) and disappearance was seen in 67.7% of cases (83.3% of generalized type epilepsy). Concommitent with the larger number of anticonvulsants a longer duration of epilepsy and more frequent seizure attack was showed more lower disappearance rate of seizure attack. Adverse event weight loss(9.4%), somnolence(7.3%), dizziness(5.2%), skin rash, decreased cognitive function, nocturia(3.1%) and headache(2.1%) were noted, but were mostly not serious. CONCLUSION: TPM seems to be a promising new broad-spectrum anticonvulsant, which is efficacious and safe in children with intractable epilepsy.