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Efficacy of topiramate in children with refractory status epilepticus

Mustafa Kahriman1, Daniela Minecan, Ekrem Kutluay

  • 1Department of Neurology, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.

Epilepsia
|September 27, 2003
PubMed

Insights

Topiramate (TPM) effectively terminated status epilepticus (SE) in three treatment-resistant pediatric cases. This study suggests TPM may be a viable option for refractory SE in children.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Pharmacology

Background:

  • Status epilepticus (SE) is a critical neurological emergency with high morbidity and mortality.
  • Current SE treatments occasionally fail, necessitating alternative therapeutic strategies.
  • Topiramate (TPM) has shown anecdotal efficacy in adult refractory SE.

Observation:

  • A retrospective review identified three pediatric patients with refractory SE.
  • These patients had not responded to standard treatments including benzodiazepines, phenytoin, phenobarbital, midazolam, or pentobarbital.
  • Topiramate was administered via nasogastric tube and patients were monitored via EEG.

Findings:

  • All three pediatric patients achieved seizure termination within 24 hours of TPM therapy.
  • TPM was initiated at 2-3 mg/kg/day and escalated to a maintenance dose of 5-6 mg/kg/day.
  • Successful treatment was observed in infants and older children.

Implications:

  • Topiramate demonstrates potential efficacy as a treatment for refractory status epilepticus in children.
  • These findings warrant further investigation in larger, prospective studies.
  • TPM may offer a new therapeutic avenue for challenging pediatric SE cases.
Abstract

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