Topiramate in the treatment of myoclonic-astatic epilepsy in children: a retrospective hospital audit.

Abstract

BACKGROUND:

Myoclonic-Astatic Epilepsy (MAE) usually starts before five years of age and is associated with very frequent seizures and is highly resistant to treatment.

AIM:

To investigate the outcome of adjunctive topiramate (TPM) therapy in children with a diagnosis of MAE syndrome.

SUBJECTS AND METHODS:

In an outpatient setting, case notes of 27 children who received TPM were retrieved and analysed.

RESULTS:

Records of 6 children with MAE, who were experiencing 2-8 atonic seizures daily before starting TPM were studied. Improvement was noted after addition of TPM (mean dose at steady-state 7.4+/-2.5mg/kg/day) to the regimen of 1-3 anti-epileptic drugs they were receiving concurrently. All but one child improved following the titration period: one had 50-80% improvement in the frequency of atonic seizures and three had over 80% improvement. However, one child who showed over 80% improvement and was free of atonic seizures, later developed increased frequency of other seizure types. In one child there was no significant improvement. Improvement has been sustained for over 6 months in three patients and over 4 months in one; three have continued TPM. TPM was stopped in three patients (reduction in seizure control/no improvement).

CONCLUSIONS:

This study supports the efficacy of TPM in controlling atonic seizures in MAE and indicates that it should be considered as an add-on drug in the management of this 'difficult-to-treat' epileptic syndrome.

• Authors: S Jayawant, S E Libretto
• Journal: Journal of postgraduate medicine (J Postgrad Med) 2003 Jul-Sep Vol. 49 Issue 3 Pg. 202-5; discussion 205-6 ISSN: 0022-3859 [Print] India
• PMID: 14597780 (Publication Type: Journal Article)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose

Topics

• Adolescent
• Anticonvulsants (therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination
• Epilepsy, Absence (drug therapy)
• Female
• Fructose (analogs & derivatives, therapeutic use)
• Humans
• Male
• Medical Audit
• Myoclonic Epilepsy, Juvenile (drug therapy)
• Retrospective Studies
• Topiramate
• Treatment Outcome
• United Kingdom