OBJECTIVE: This was an open-label, long-term, retrospective observation. 227 patients with symptomatic
epilepsy (110 male, 117 female) were enrolled into this study. The underlying aetiologies included low-grade brain tumour,
head trauma,
cerebrovascular diseases,
infection,
diabetes mellitus,
hydrocephalus and parasitosis.
Topiramate was titrated up to a target dosage of 200 mg/day and maintained for at least 1 year. Response to
topiramate was defined as > or = 50% reduction in seizure frequency compared with baseline. Seizure free was defined as no seizure occurring during 1 year of
topiramate therapy.
RESULTS: 157 (69.2%) patients were responders and 124 (54.6%) patients were seizure free with
topiramate administration. Responders by subgroup included 40 patients (74.0%) with low-grade brain tumour, 32 (55.2%) with
trauma, 30 (90.9%) with
cerebrovascular disease, 21 (55.3%) with
infection, 18 (81.8%) with diabetes, 12 (85.7%) with parasitosis and 4 (50.0%) with
hydrocephalus. The percentage of seizure-free patients by subgroup was 61.0% with brain tumours, 31.0% with
trauma, 78.8% with
cerebrovascular disease, 44.7% with
infection, 59.0% with diabetes, 85.7% with parasitosis and 50.0% with
hydrocephalus. The incidence of adverse effects was 36.1%. The most commonly reported adverse effects were
weight loss, memory impairments, paraesthesia,
headache and
dizziness; most were mild to moderate in severity and transient. Sixty-eight (30.0%) patients withdrew from
topiramate treatment in this study:
topiramate was discontinued in 56 patients because of lack of efficacy and in 12 patients because of adverse effects. At the end of the study, 109 patients received
topiramate monotherapy, including 52 newly diagnosed patients and 57 subjects who transferred to
topiramate monotherapy successfully; another 118 patients received add-on
topiramate therapy. The percentage of patients responding to
topiramate was 85.3% in the monotherapy group and 54.2% in the
topiramate add-on therapy group; the percentage of seizure-free patients was 68.8% in the
topiramate monotherapy group and 41.5% in the
topiramate add-on therapy group.
CONCLUSION: When administered either as a single drug or as an add-on drug,
topiramate is effective and well tolerated in adult patients with symptomatic
epilepsy of various aetiologies.