Topiramate as Add-On Drug in Childhood Refractory Partial-Onset Seizures: Report on 55 Cases.
Abstract number :
3.047
Submission category :
Year :
2000
Submission ID :
2685
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Coppola Giangennaro, Caliendo Grazia, Terracciano Maria Maddalena, Buono Salvatore, Pascotto Antonio, Clin of Child Neuropsychiatry, Second Univ of Naples, Naples, Italy; Clin of S Maria del Pozzo, Naples, Italy; Santobono Hosp, Naples, Italy.
RATIONALE:The efficacy and safety of Topiramate (TPM), a new antiepileptic medication, was evaluated in an open trial as adjunctive therapy in 55 uncontrolled cryptogenic or symptomatic epilepsy outpatients, aged 2 to 30 years ( mean age 15 years), affected by partial-onset seizures with or without secondary generalized seizures.Mental delay of various degrees was present in 49.1% of cases. METHODS:after a baseline observation period of 6 months,TPM was added to the previous 1-2 AEDs at the initial dose of 0.5-1 mg/kg/24 hr. The drug was slowly titrated with 1-3 mg/kg daily every second week with an estimated target dose if 12 mg/kg daily. RESULTS: after a mean period of 9 months, TPM induced a 100% decrease in seizure frequency in 11 patients(20%), more than 50% in 25% (45.5%), and by 25-50% in 5(9.1%). Seizure frequency remained unchanged in 8 (14.5%) and increased in 6 (10.9%). Twenty-five patients(45.4%) experienced mostly dose-dependent adverse side effects such as hyporexia and weight loss, fatigue, cognitive dulling and psychotic-like symptoms which however did not cause themselves TPM withdrawal in all patients but one. CONCLUSIONS: it is concluded that TPM seems to be a promising new broad-spectrum antiepileptic drug, although careful monitoring of cognitive and behavioural functions is required.