Abstracts

Rationale: Conventional therapeutic regimen for status epilepticus (SE) may require mechanical ventilation and hemodynamic support, and is associated with significant complications and increased mortality. We investigated the safety and effectiveness of topiramate (TPM) in patients with refractory SE or recurrent generalized convulsive seizures who had serious medical complications such as systemic infection, renal or hepatic dysfunction, and bone marrow suppression.Methods: We analyzed the clinical features and therapeutic outcome in 25 patients with generalized convulsive SE, nonconvulsive SE or recurrent generalized convulsive seizures in whom TPM was administered for its control.Results: The majority of our patients had GCSE (n=12) or NCSE (n=13). The common co-morbid diseases at the onset of seizures were hematological disorders (pancytopenia 8, anemia 4, anemia with thrombocytopenia 4) and sepsis (n=10). Sixteen patients were under the renal and/or hepatic dysfunction. Within a few days, 19 patients could experience their seizure control (the mean duration, 3.9± 2.8 days), but the seizures of the other subjects was not terminated in spite of all efforts. No patients experienced worsening of their CBC or blood chemistry profiles possibly related to the treatment with TPM.Conclusions: TPM was not only safe but very effective for the control of recurrent epileptic seizures or SE in patients with serious medical co-morbidities. TPM may be considered as another treatment option when conventional protocols are ineffective.