Effect of topiramate on intractable seizures in Taiwanese children

Area of Science:

• Pediatric Neurology
• Clinical Pharmacology
• Epileptology

Background:

• Intractable epilepsy in children poses significant treatment challenges.
• Existing antiepileptic drug (AED) regimens are often insufficient for severe cases.
• Need for effective adjunctive therapies in pediatric epilepsy populations.

Purpose of the Study:

• To prospectively evaluate topiramate as an adjunctive therapy for intractable epilepsy in Taiwanese children.
• To assess the efficacy and safety of topiramate in pediatric patients with partial and generalized epilepsy.
• To determine seizure reduction rates and identify adverse effects associated with topiramate treatment.

Main Methods:

• Prospective study involving 30 Taiwanese children (2-16 years) with intractable epilepsy.
• Topiramate initiated at 1 mg/kg/day, titrated up to 10 mg/kg/day over 4+ weeks.
• Patients received stable background AEDs; seizure frequency monitored pre- and post-treatment.

Main Results:

• In partial epilepsy (n=18): 33.3% achieved ≥50% seizure frequency reduction; 44.4% became seizure-free.
• In generalized epilepsy (n=12): 33.3% achieved ≥50% seizure frequency reduction; 41.7% became seizure-free.
• Most common adverse effect was poor appetite (10.0%); no idiosyncratic reactions observed.

Conclusions:

• Topiramate demonstrates efficacy as an adjunctive treatment for intractable partial and generalized epilepsy in Taiwanese children.
• The drug is generally well-tolerated, with a favorable safety profile in this pediatric cohort.
• Topiramate represents a viable therapeutic option for children with refractory epilepsy.