Abstracts

Topiramate (TPM) is a newer antiepileptic drug (AED) approved for use in patients above 2 years as add-on for partial (PE) and generalized epilepsy (GE). The objective of this study was to evaluate the efficacy and tolerability of TPM monotherapy. We retrospectively reviewed the records of epileptic children seen at our institution during 2001-2003, and who were on TPM monotherapy Forty-two patients (21M, 21F), ages 0.5-23 years (mean 9.7 years) were identified. Fifty-five percent had developmental delay/mental retardation. Type of epilepsy was PE in 71%, idiopathic GE (IGE) in 17%, and symptomatic GE (SGE) in 12%. Range of TPM dose was 1-19 mg/kg/day (mean 6.0 mg/kg/day). Follow-up range was 0.5-5 years (mean 2.2 years). TPM was started as first-line monotherapy in 10 patients (24%), and as adjunctive therapy in 32 (76%), due to ineffectiveness (22) or side effects (10) of other AEDs. Mean number of previous AEDs was 1.2 (range 0-5). Global seizure reduction was as follows: 100% in 26 (62%), 75-99% in 2 (5%), 50-74% in 4 (9.5%), and [lt]25 % in 10 (24%). Overall, 32 (76%) patients showed [gt]50% reduction in seizure frequency. According to epilepsy type, seizure reduction was as follows: PE: [gt]50% in 73%, 60% seizure-free, and [lt]25% in 27%. IGE: [gt]50% in 86%, 71% seizure-free, and [lt]25% in 14%. SGE: [gt]50% in 80%, 60% seizure-free, [lt]25% in 20%. Three patients (7%) had side effects: weight loss, memory difficulties, and lethargy. TPM proved to be effective and safe as monotherapy in various types of pediatric epilepsy.