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Long-term response to topiramate in patients with West syndrome
T A Glauser1, P O Clark, K McGee
1Children's Comprehensive Epilepsy Program, Department of Neurology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. glauser@chmcc.org
Purpose:
The long-term effectiveness of topiramate (TPM) was evaluated in children with West syndrome previously refractory to antiepileptic drug (AED) therapy.
Methods:
Children with infantile spasms who completed a pilot study were eligible to enter a long-term extension phase in which the dosages of TPM and other AEDs could be adjusted to optimal response (maximum, 50 mg/kg/day TPM). The mean duration of long-term therapy was 18 months in the 11 children who were followed; the mean TPM dosage was 29 mg/kg/day.
Results:
Eight (73%) children were continuing TPM therapy at the time data were analyzed; four (50%) children were spasm free, seven (88%) had experienced a > or =50% reduction in spasms, and three (38%) were able to achieve TPM monotherapy.
Conclusions:
TPM was well tolerated in that no patients discontinued because of adverse events. The response achieved with TPM during the pilot study was maintained in most children.