Nightly oral administration of topiramate for benign childhood epilepsy with centrotemporal spikes

Area of Science:

• Pediatric Neurology
• Epileptology
• Pharmacology

Background:

• Benign childhood epilepsy with centrotemporal spikes (BECTS) is a common epilepsy syndrome in children.
• Current treatment strategies for BECTS often involve daily antiepileptic drug administration.
• Optimizing treatment regimens for efficacy and tolerability is crucial in pediatric epilepsy management.

Purpose of the Study:

• To evaluate the feasibility of a once-nightly oral administration of topiramate for BECTS.
• To compare the clinical efficacy, EEG changes, and adverse reactions of nightly versus twice-daily topiramate dosing.
• To determine if a simplified dosing schedule can maintain therapeutic benefits while improving tolerability.

Main Methods:

• A randomized controlled trial involving 85 children diagnosed with BECTS.
• Group A (44 patients) received topiramate 2 mg/kg/day orally once nightly.
• Group B (41 patients) received topiramate 4 mg/kg/day orally twice daily.
• Assessment included clinical seizure control, EEG activity, and adverse events over a 12-month follow-up.

Main Results:

• No significant differences were observed in overall efficacy, seizure-free rates, or EEG changes between the nightly and twice-daily topiramate groups.
• The incidence of adverse reactions in the nightly administration group (9.1%) was significantly lower than in the twice-daily group (29.3%).
• Statistical analysis confirmed the significant reduction in adverse events with the nightly regimen (χ(2) = 4.262, P < 0.05).

Conclusions:

• Once-nightly oral administration of topiramate is a feasible and effective treatment option for BECTS.
• This simplified dosing regimen provides comparable efficacy to twice-daily dosing.
• Nightly topiramate administration offers improved convenience and a significantly better safety profile for children with BECTS.