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 |
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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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