Objectives:

We evaluated the clinical results of topiramate in epileptic children.

Patients and Methods:

The efficacy of topiramate was retrospectively aşeşed in 88 children (39 girls, 49 boys; mean age 8.3 years; range 4 months to 18 years). Most of the patients had symptomatic (n=64) and/or refractory epilepsy (n=73) to at least three antiepileptic drugs. Response to treatment was evaluated as complete disappearance of seizures or partial decrease of more than 50%. Daily initial and final doses ranged from 0.6 to 1.1 mg/kg and 3.2 to 15 mg/kg, respectively, with a mean duration of 11 months (range 6 to 38 months).

Results:

Forty-eight patients (57%) responded to topiramate treatment, 14 of whom were seizure-free. Response rates were as follows: partial epilepsy 66% (39/59), generalized epilepsy 41.7% (5/12), and epileptic syndromes 30% (4/13). Response was 66% in partial seizures (38/58) and 48.4 in generalized seizures (15/31). Treatment was discontinued because of somnolence in four patients, increase in the frequency of seizures in three patients, and hyperthermia in one patient. Adverse effects were anorexia (n=14), weight loş (n=11), difficulty in concentration (n=8), somnolence (n=7), deterioration in speech (n=6), and fever (n=3).

Conclusion: Topiramate seems to be a safe and effective antiepileptic drug; however, it should be used considering its special side effect profile.

Keywords: Anticonvulsants/therapeutic use/adverse eff e c t s;child; epilepsy/drug therapy; epilepsies, partial/drug therapy;fructose/therapeutic use/analogs & derivatives; treatment outcome.