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Clinical Study of Effectiveness Topiramate in Children with Intractable Epilepsy

Journal of the Korean Pediatric Society 2001;44(1):62-67.
Published online January 15, 2001.
Clinical Study of Effectiveness Topiramate in Children with Intractable Epilepsy
Young Mi Choi, Sa Jun Chung
Department of Pediatrics, College of Medicine, Kyunghee University, Seoul, Korea
난치성 간질 환아에서 Topiramate 효과에 대한 임상적 연구
최영미, 정사준
경희대학교 의과대학 소아과학교실
Abstract
Purpose
: Topiramate(TPM) is a new anticonvulsant with multiple action mechanisms which should theoretically represent a wide therapeutic spectrum. However, there is still little clinical experience of its use in Asian children with epilepsy.
Methods
: The patients were total 96 children who were treated with more than 2 anticonvulsants but poorly controlled seizure activity. TPM was given as add-on therapy and evaluated the efficacy and adverse events prospectively. This study consisted of 8 weeks of baseline phase, 10- 16 weeks titration phase, and 8 weeks of stabilization phase. Clinical efficacy was classified into 4 groups : disappearance, marked improvement, improvement, no improvement.
Results
: When TPM was prescribed, a response of >50% reductions in seizure attacks was seen in 90.6% of cases(95.5% of partial type epilepsy) and disappearance was seen in 67.7% of cases (83.3% of generalized type epilepsy). Concommitent with the larger number of anticonvulsants a longer duration of epilepsy and more frequent seizure attack was showed more lower disappearance rate of seizure attack. Adverse event weight loss(9.4%), somnolence(7.3%), dizziness(5.2%), skin rash, decreased cognitive function, nocturia(3.1%) and headache(2.1%) were noted, but were mostly not serious.
Conclusion
: TPM seems to be a promising new broad-spectrum anticonvulsant, which is efficacious and safe in children with intractable epilepsy.
Key Words: Topiramate, Partial seizure


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