Prospective study of first-choice topiramate therapy in newly diagnosed infantile spasms.

Abstract

OBJECTIVE:

This was a prospective open study to establish the efficacy, tolerability, and problems associated with the use of topiramate as first-choice drug in children with infantile spasms.

METHODS:

Open-label follow-up study, ranging from 24 to 36 months, of the cases of 54 patients with infantile spasms treated initially with topiramate as first-choice drug.

RESULTS:

Thirty-one patients (57.4%) were seizure free for more than 24 months; 9 patients were treated with topiramate alone and 22 patients with topiramate plus nitrazepam and/or valproate. In 44 cases (81.4%), the reduction of seizure frequency from baseline was greater than 30%, whereas in 10 cases (18.6%), there was poor or no response. The average dosage applied was 5.2 mg/kg per day (maximum dosage, 26 mg/kg per day; minimum dosage, 1.56 mg/kg per day). Adverse events occurred in 14 patients (26%). They included poor appetite leading to anorexia, absence of sweating, and sleeplessness.

CONCLUSIONS:

Topiramate proves to be an effective and safe first-choice drug not only as adjunctive but also as monotherapy of infantile spasms in children younger than 2 years.

• Authors: Li-Ping Zou, Chang-Huan Ding, Fang Fang, Ngai-Chuen Sin, Eilhard Mix
• Journal: Clinical neuropharmacology (Clin Neuropharmacol) 2006 Nov-Dec Vol. 29 Issue 6 Pg. 343-9 ISSN: 0362-5664 [Print] United States
• PMID: 17095898 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Anticonvulsants
• Topiramate
• Fructose

Topics

• Anticonvulsants (therapeutic use)
• Drug Administration Schedule
• Electroencephalography (methods)
• Follow-Up Studies
• Fructose (analogs & derivatives, therapeutic use)
• Humans
• Infant
• Prospective Studies
• Retrospective Studies
• Spasms, Infantile (diagnosis, drug therapy)
• Topiramate
• Treatment Outcome