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DOI: 10.1055/s-0029-1234103
© Georg Thieme Verlag KG Stuttgart · New York
Effectiveness of Low Dose of Topiramate Following Rapid Titration in Multiply Handicapped Children and Difficult-to-Treat Epilepsy
Publication History
received 22.06.2008
accepted 13.07.2009
Publication Date:
06 October 2009 (online)
Abstract
This prospective, observational, single arm, monocentric study explored efficacy and tolerability outcomes of rapid oral initiation of topimarate in children with difficult to treat epilepsy. The study population consisted of 19 multiply handicapped children (mean age 4.4 years, range 0.6–15.3 years). The observation period was 12 weeks and included 7 visits. The mean initial dose of topiramate was 1.1 mg/kg body weight/d (range: 0.66–2.67 mg/kg/d) following rapid titration. The mean final dose was 3.3 mg/kg/d (range 0.5–6.7 mg/kg/d). An at least 50% reduction of seizure frequency compared to baseline was observed in 9 of 19 patients (47.4%). Six patients (31.6%) had a slight reduction of seizure frequency (<50%) and 4 patients (21.1%) experienced an increase of seizure frequency. A total number of 29 adverse events were documented in 17 of 19 patients. Most frequently captured were fatigue (26.3% of patients), decreased appetite (15.8%) and psychiatric disturbances (15.8%). No serious adverse events were reported. These data might suggest that in certain clinical circumstances rapid dose escalation with topiramate followed by a low maintenance dose might be a good therapeutic option for pediatric patients with difficult to treat epilepsy.
Key words
topiramate - difficult to treat epilepsy - children - rapid titration - low dose - focal seizures - generalized seizures
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Correspondence
Dr. Gerhard Kluger
Klinik für Neuropädiatrie und Neurologische Rehabilitation
Epilepsiezentrum für Kinder und Jugendliche
BHZ Vogtareuth
Krankenhausstraße 20
83569 Vogtareuth
Germany
Phone: +49/8038/901 4 11
Fax: +49/8038/901 34 11
Email: gkluger@schoen-kliniken.de