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| ORIGINAL ARTICLE |
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| Year : 2003 | Volume
: 49
| Issue : 3 | Page : 202-206 |
Topiramate in the Treatment of Myoclonic-Astatic Epilepsy in Children: A Retrospective Hospital Audit
S Jayawant, SE Libretto
Department of Childhood Health, Paediatric Neurology Service, University Hospital of Wales, Cardiff, CF14 4XW and Janssen-Cilag Ltd., Saunderton, High Wycombe, Buckinghamshire HP14 4HJ, United Kindom
Correspondence Address:
S E Libretto
Janssen-Cilag Ltd., Saunderton, High Wycombe, Buckinghamshire HP14 4HJ
United Kindom
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 14597780 
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.
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