Topiramate as a long-term therapy in children with refractory epilepsy
Aycan Unalp1, Nedret Uran, Tulin Hizli
1Department of Pediatric Neurology, Behcet Uz Child Diseases and Pediatric Surgery Training and Research Hospital, Izmir, Turkey. Tel. +90 (232) 2387097. Fax. +90 (232) 3668530.
Insights
Topiramate (TPM) showed moderate long-term effectiveness and tolerability in childhood refractory epilepsies, particularly in localization-related cases. Retention rates were 43.6%, with 25.3% achieving seizure freedom.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epileptology
Background:
- Refractory epilepsies in children pose significant treatment challenges.
- Long-term data on antiepileptic drugs like topiramate (TPM) are crucial for clinical practice.
Purpose of the Study:
- To assess the long-term efficacy, safety, and retention of topiramate (TPM) in pediatric patients with refractory epilepsies.
- To identify factors influencing treatment outcomes in this population.
Main Methods:
- Retrospective, single-center study involving children with refractory epilepsy treated between 2003 and 2007.
- Analysis of treatment response, retention rates, seizure freedom, adverse events, and long-term efficacy.
Main Results:
- Initial good response observed in 71.8% of patients.
- Long-term retention rate was 43.6% at a mean of 32 months, with 25.3% seizure-free.
- Adverse events occurred in 28.1% of children; loss of efficacy noted in 33.3% of initial responders.
Conclusions:
- Topiramate (TPM) demonstrated moderate long-term efficacy and tolerability in childhood refractory epilepsies.
- The drug was found to be more effective and better tolerated in localization-related epilepsies compared to generalized forms.
- No significant differences were observed between groups who continued or discontinued TPM treatment long-term.
Objective:
To evaluate the long-term efficacy, safety, and retention rate of topiramate (TPM) in childhood refractory epilepsies.
Methods:
This study was designed as a single-center, retrospective study. Children with refractory epilepsy who has been followed in Behcet Uz Children`s Hospital, Izmir, Turkey, between 2003 and 2007 were included in the study.
Results:
The study population consisted of 43 boys (60.6%), and 28 girls (39.4%) aged between 2-18 years. Mean age was 8.83 (SD: 3.77) and mean duration of epilepsy was 3.89 (SD: 1.51) years. There were 41 children (57.7%) with mental retardation. Twenty-seven children had generalized epilepsy, and 44 children had localization-related epilepsy. Fifty-one children (71.8%) showed a good response to initial treatment. The retention at a mean of 32 months was 31 out of 71 children (43.6%), and approximately 18 children (25.3%) were seizure free. A loss of efficacy in long-term use occurred in 17 (33.3%) of initial responders. Adverse events were seen in 20 children (28.1%). There were no significant differences between the groups who continued and discontinued TPM treatment in long-term use.
Conclusion:
As a result, it was determined that the drug was more effective and well tolerated in localization-related epilepsies, on long-term follow up.
Related Concept Videos
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
01:14Antiepileptic Drugs: Glutamate Antagonists
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:08Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
01:17Antiepileptic Drugs: Calcium Channel Blockers
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...