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Topiramate loading for refractory status epilepticus in children
M Scott Perry1, Philip J Holt, John T Sladky
1Emory University Department of Pediatrics, Division of Pediatric Neurology, Atlanta, Georgia 30322, USA. scott_perry@oz.ped.emory.edu
Epilepsia
|July 11, 2006
Summary
Topiramate (TPM) effectively treated refractory status epilepticus (RSE) in three pediatric cases. This epilepsy treatment successfully aborted seizures within 21 hours, avoiding pharmacologic coma in most patients.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epileptology
Background:
- Refractory status epilepticus (RSE) in children poses significant treatment challenges.
- Established antiepileptic drugs (AEDs) are often insufficient for managing prolonged seizures.
- Identifying novel and effective therapeutic agents for RSE is crucial.
Observation:
- Three pediatric patients with RSE, refractory to multiple AEDs, were treated with topiramate (TPM).
- A loading dose of TPM (10 mg/kg/d for 2 days) was administered, followed by a maintenance dose (5 mg/kg/d).
Findings:
- Topiramate successfully aborted status epilepticus in all three cases within 21 hours of the initial dose.
- Two patients avoided the need for pharmacologic coma induction.
- One patient was rapidly weaned from continuous benzodiazepine infusion.
Implications:
- Topiramate loading demonstrates potential efficacy as an adjunctive treatment for pediatric RSE.
- This approach may offer a viable alternative to induce pharmacologic coma in refractory cases.
- Further research into TPM's role in managing pediatric RSE is warranted.
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