Abstracts

Topiramate(TPM) has been found efficacious as adjunctive therapy in controlled, randomized trials with chronic refractory partial onset seizures. TPM was also shown to be effective when converted from adjunctive therapy to monotherapy. Because initial studies of new antiepileptic drugs(AEDs) are add-on trials in refractory patient populations, their effectiveness as monotherapy is usually not apparent until relatively later in their development programs.
This study enrolled patients who had been diagnosed with epilepsy and who had experienced 1-6 seizures during the 3 month retrospective baseline. We report a retrospective study in patients less than 15 years of age to evaluate TPM as monotherapy in Korean children with recently diagnosed epilepsy. TPM was given at a dose of 1mg/kg per day, with a progressive titration of 1mg/kg a week. The frequency of seizure attacks, type of seizure and occurrence of adverse effects of topiramate were monitored for evaluation of effectiveness.
37 patients were studied to evaluate TPM as monotherapy. TPM was effective in 76% of 21 patients with partial epilepsy, and in 68% of 16 patients with generalized epilepsy. 73% of the patients were still receiving TPM at the time of the analysis. Improvement was well maintained in all patients during the treatment period(median 6.8 months). Seizure frequency and severity increased in 13% of patients with partial epilepsy and 17% with generalized epilepsy, and resulted in withdrawal of TPM for 9%. The most frequently reported adverse events were moderate neurobehavioral disorders.
TPM is effective and well tolerated in children under 15 years of age in a broad range of epilepsy syndromes, including idiopathic patial epilepsy, and generalized epilepsy. Use of TPM as monotherapy could be considered in children with epilepsy, and slow titration is required. The results of this analysis suggest that TPM may prove to be a new AED for monotherapy in children
[Supported by: Wonkwang University in 2003]