Topiramate treatment for nocturnal frontal lobe epilepsy.

Abstract

PURPOSE:

Aim of this study was to evaluate the efficacy and tolerability of the antiepileptic drug topiramate (TPM) in a sample of patients with nocturnal frontal lobe epilepsy (NFLE).

METHODS:

A 24 patients with video-polysomnographically confirmed NFLE received topiramate as single or add-on therapy. They all completed diaries concerning the seizures frequency and complexity and underwent to periodic follow-up visits. We classified the patients as: seizure-free, responders or non-responders.

RESULTS:

15 M; 9 F; mean age 29.3+/-10.4 years. The video-polysomnographic recordings showed a wide spectrum of seizures, ranging from repeated stereotypic brief motor attacks to prolonged attacks, with complex and bizarre behaviour; the recorded episodes occurred during non-REM sleep, both stage 2 and stage 3-4. The EEG during wakefulness was normal in all the patients, while seven of them showed epileptiform abnormalities during polysomnography. TPM was administered as single or add-on therapy from 50 to 300mg daily at bedtime. The follow-up duration ranged from 6 months to 6 years. The patients were classified as: seizure-free=6 (25%); responders (reduction of at least 50% of seizures)=15 (62.5%); non-responders=3 (12.5%). The adverse events were: weight loss (6 pts, 25%); paresthesias (3 pts, 12.5%); speech dysfunction (2 pts, 8.3%). All the adverse events disappeared within 3 months.

CONCLUSIONS:

In our experience, TPM seems to be effective in about 90% of patients with NFLE. Few of them experienced transitory adverse events. TPM could be included in the options for patients with this form of epilepsy.

• Authors: Alessandro Oldani, Mauro Manconi, Marco Zucconi, Cristina Martinelli, Luigi Ferini-Strambi
• Journal: Seizure (Seizure) Vol. 15 Issue 8 Pg. 649-52 (Dec 2006) ISSN: 1059-1311 [Print] England
• PMID: 16973383 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose

Topics

• Adult
• Anticonvulsants (therapeutic use)
• Drug Therapy, Combination
• Epilepsy, Frontal Lobe (drug therapy, physiopathology)
• Female
• Follow-Up Studies
• Fructose (analogs & derivatives, therapeutic use)
• Humans
• Male
• Polysomnography
• Sleep (physiology)
• Sleep Stages (physiology)
• Topiramate
• Treatment Outcome
• Video Recording