Abstracts

Topiramate (TPM) is a new antiepileptic drug (AED), which has a wide spectrum of activities suggesting a potentially valuable therapeutic profile. Our objective is to report our experience with TPM in the treatment of intractable childhood epilepsy.
Prospective, open label, add on trial of TPM in treating consecutive children with intractable epilepsy (defined as recurrent seizures after at least 3 antiepileptic medication trials). Follow up by two pediatric neurologists was performed. Therapeutic response was recorded as complete (no seizures), Good ([gt]50% seizure reduction), fair ([lt]50% seizure reduction), or none.
62 children (36 males - 26 females), aged 1 month-16 years (mean 6 y) were treated with TPM for 1 month-3 year. Most children (55%) had daily seizures and were tried on multiple antiepileptic drugs (mean 4.6). Nineteen (31%) children had Lennox-Gastaut Syndrome. After the introduction of TPM, 21 (34%) became completely seizure free and 24 (39%) had [gt]50% seizure reduction. Side effects were reported in 21 (34%) in the form of decreased appetite, weight loss, and sedation. Most of the side effects were transient, however, TPM had to be withdrawn in 7 children because of excessive weight loss (6%) and seizure worsening (5%). Follow-up renal ultrasound was performed on 34 (55%) children and was always normal.
Topiramate is a very effective antiepileptic drug with broad spectrum of antiepileptic activities. Most side effects were transient, however, careful monitoring of the body weight is recommended.