Topiramate in Intractable Childhood Onset Epilepsy - A Cautionary Note

To study the effectiveness and safety of topiramate in clinical practice, for a group of patients with childhood onset epilepsy. All patients treated with topiramate at the three study centers between November 1995 and December 31, 1997 were analyzed retrospectively, using a standardized study proto...

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Bibliographic Details
Published in:	Canadian journal of neurological sciences 1999-11, Vol.26 (4), p.271-273
Main Authors:	Dooley, J.M., Camfield, P.R., Smith, E., Langevin, P., Ronen, G.
Format:	Article
Language:	eng
Subjects:	Adolescent Age of Onset Anticonvulsants - adverse effects Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences Child Child, Preschool Epilepsies, Myoclonic - drug therapy Epilepsy - drug therapy Epilepsy, Absence - drug therapy Epilepsy, Complex Partial - drug therapy Epilepsy, Generalized - drug therapy Fructose - adverse effects Fructose - analogs & derivatives Humans Infant Medical sciences Neuropharmacology Original Articles Pharmacology. Drug treatments Retrospective Studies Topiramate
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Summary:	To study the effectiveness and safety of topiramate in clinical practice, for a group of patients with childhood onset epilepsy. All patients treated with topiramate at the three study centers between November 1995 and December 31, 1997 were analyzed retrospectively, using a standardized study protocol. Data were gathered on demographic features, seizures response and medication related adverse events. Eighty-seven patients were treated with topiramate. Over 90% seizure reduction was achieved in 8 (9%) patients, 50%-90% in 21 (24%), < 50% in 54 (62%) patients. Four patients (5%) had a deterioration in seizure control. Adverse events required topiramate discontinuation in 36 (41%). Of these 27 (31%) complained of unacceptable cognitive dulling. The rate of dose escalation and final dose in mg/kg were similar in those who remained on topiramate and those who were intolerant because of cognitive side effects. Although topiramate resulted in > 50% seizure reduction in 29 (33%) of this group of patients with difficult epilepsy, its usefulness was limited by a high incidence of adverse effects. Adverse events prevented ongoing therapy for 36 (41%) and cognitive dulling resulted in topiramate discontinuation by 27 (31%) of the group.
ISSN:	0317-1671 2057-0155