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West syndrome, can topiramate be on top?

Raidah S Al-Baradie1, Maha A Elseed

  • 1Neuroscience Center, King Fahd Specialist Hospital, PO Box 15215, Dammam 314444, Kingdom of Saudi Arabia. raidah_albaradie@hotmail.com

Neurosciences (Riyadh, Saudi Arabia)
|January 6, 2011
PubMed

Insights

Topiramate effectively reduced infantile spasms and ancillary seizures in young patients, showing clinical improvement but not significant EEG changes. The treatment was generally well-tolerated with few side effects.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology
  • Epileptology

Background:

  • Infantile spasms, a severe epilepsy syndrome, require prompt and effective treatment.
  • West syndrome is characterized by infantile spasms, hypsarrhythmia on EEG, and developmental delay.
  • Identifying effective antiepileptic drugs for infantile spasms is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of Topiramate in treating infantile spasms and associated ancillary seizures.
  • To assess the impact of Topiramate on electroencephalogram (EEG) findings in patients with infantile spasms.
  • To determine the tolerability and side effect profile of Topiramate in this pediatric population.

Main Methods:

  • A retrospective study involving 18 patients diagnosed with infantile spasms.
  • Patients were treated with Topiramate, with a maximum dosage of 12 mg/kg/day.
  • Data on seizure control, EEG changes, and adverse events were collected and analyzed.

Main Results:

  • Topiramate led to spasm freedom in 33% of patients and a ≥50% reduction in spasms in 44%.
  • For ancillary seizures, 25% of patients became seizure-free, and 25% experienced a ≥50% reduction.
  • While clinical seizure control was observed, EEG improvements were limited, with persistent hypsarrhythmia in 44% of cases. Minimal side effects were reported.

Conclusions:

  • Topiramate demonstrates significant efficacy in managing the clinical manifestations of West syndrome.
  • The drug's effect on EEG abnormalities in infantile spasms appears limited.
  • Topiramate is a well-tolerated treatment option for infantile spasms with a favorable side effect profile.
Abstract

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