Abstracts

RATIONALE: Previous study reported possible synergistic effect of allopurinol and topiramate. We observed the use of allopurinol was beneficial in the situations of intractable seizure care when topiramate was tried. METHODS: 14 patients who have intractable seizure disorder (13 partial complex, and 1 primary generallized), previously treated with multiple anticonvulsants other than topiramate, were serially treated with topiramate to the highest tolerable dose. None of them became seizure free. Allopurinol 100mg po bid was added as adjunctive therapy. Improvement was measured by seizure frequency count. RESULTS: 8 of 14 patients experienced partial improvement of seizure control by topiramate at the beginning. Among 8, 6 patients experienced definite additional improvement by subsequent allopurinol adjunctive therapy. Two patients became completely seizure free, and 4 out of the 6 had 50% reduction in seizure frequency. 2 of the 8 patients did not have improvement. Among the 6 patients who did not respond to topiramate, 5 patients did not have clinical improvement by allopurinol adjunction while the patient with primary generalized seizure improved by subsequent allopurinol addition. EEG and MRI findings did not predict whether allopurinol worked. CONCLUSIONS: Addition of low dose allopurinol may more likely salvage seizure control if topiramate shows partial palliative effect. The study confirmed that allopurinol adjunctive therapy correlates with the effects of topiramate in partial seizure disorder.