Document Detail


Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms: with special reference to electroencephalographic changes.
MedLine Citation:
PMID:  22698380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES.
METHODS: Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤ 12 years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings.
RESULTS: The median age at the start of TPM treatment was 5 years, 8 months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥ 50% reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated.
CONCLUSIONS: TPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects.
Authors:
Fumika Endoh; Katsuhiro Kobayashi; Yumiko Hayashi; Takashi Shibata; Harumi Yoshinaga; Yoko Ohtsuka
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-13
Journal Detail:
Title:  Seizure     Volume:  21     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-07-17     Completed Date:  2012-11-20     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  522-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / therapeutic use*
Child
Child, Preschool
Electroencephalography / drug effects*
Epilepsy / drug therapy*
Female
Fructose / analogs & derivatives*,  therapeutic use
Humans
Infant
Infant, Newborn
Male
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0H73WJJ391/topiramate; 30237-26-4/Fructose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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