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Topiramate for Seizures in Preterm Infants and the Development of Necrotizing Enterocolitis

Benjamin Courchia1, Waleed Kurtom2, Alyssa Pensirikul3

  • 1Divisions of Neonatology and benjamin.courchia@jhsmiami.org.

Pediatrics
|June 16, 2018
PubMed

Insights

Topiramate is increasingly used for neonatal seizures, but a case series suggests a link to necrotizing enterocolitis in preterm infants. Further research is needed to understand this potential risk.

Area of Science:

  • Neonatal Neurology
  • Pediatric Pharmacology
  • Gastroenterology

Background:

  • Neonatal seizures pose significant neurodevelopmental risks.
  • No FDA-approved antiepileptic drugs exist for neonates, leading to off-label use.
  • Topiramate is a commonly used third-line treatment for neonatal seizures.

Observation:

  • This study reports on 4 preterm neonates treated with oral topiramate for seizures between 2015 and 2017.
  • All neonates developed clinical and radiographic signs of necrotizing enterocolitis after topiramate administration.

Findings:

  • Necrotizing enterocolitis presented with abdominal distention, hemoccult-positive stools, and intestinal pneumatosis.
  • The findings suggest a potential association between topiramate use and necrotizing enterocolitis in preterm infants.

Implications:

  • The findings highlight a potential adverse event associated with topiramate in a vulnerable neonatal population.
  • Further research is crucial to investigate risk factors and establish causality.
  • This underscores the need for careful monitoring and consideration of alternative treatments.

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