[The value of topiramate used with conventional schemes as an adjunctive therapy in the treatment of Lennox-Gastaut syndrome].
BACKGROUND
Lennox Gastaut syndrome (LGS), which appears in children aged between 2 and 8 years old, is characterised by a triad of epileptic seizures with different patterns, variable degrees of mental retardation, an electroencephalogram (EEG) with slow spike wave complexes at 1.5 4 Hz and bursts of rapid centrotemporal activity, with a variable response in the control of the epileptic seizures. It requires polytherapy with associations between conventional and new antiepileptic drugs, including topiramate, with variable results in the control of seizures, especially in this syndrome, which has no known response in Mexico. Aim. To determine how it responds when topiramate (TPM) is associated with another antiepileptic drug, in order to diminish the recurrence of seizures by 50% and to improve the quality of life of Mexican children.


METHODS
The study was conducted in a sample of 15 children aged between 2 and 15 years old who had been diagnosed as suffering from LGS and who used more than three conventional antiepileptic drugs. After obtaining prior authorisation from the person in charge, the frequency, duration and clinical patterns of the seizures were evaluated. Since the dosages used and the serum levels, which should be within those considered to be therapeutic, were already known for each of the subjects, we administered a Quolie 10 survey before beginning with TPM. Those who presented no modifications in the frequency and duration of the seizures over a two month period were included and treatment began gradually with 2 mg/kg/day and rose to 10 mg/kg/day as the maximum dosage. Once the frequency and duration had diminished by more than 50%, the decision was made to stop more than two antiepileptic drugs, but preferably to continue with the valproic acid. The result obtained from 15 children was a remission in over 50% of the cases and an improvement in the quality of life of the children, despite the fact that the duration ranged from six months to a year.


CONCLUSIONS
In this group of patients TPM is useful for the control or remission of seizures and, consequently, we suggest it should be administered in the Mexican population associated with valproic acid or new antiepileptic drugs.
Alva-Moncayo
E
E
Hospital Dr. Gaudencio Gonzalez Garza. Centro Medico Nacional La Raza., Mexico DF, Mexico. edith58@prodigy.net.mx
Ruiz-Ruiz
A
A
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D011788:Quality of Life; D013577:Syndrome; D000077236:Topiramate; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D004338:Drug Combinations; D000077236:Topiramate; D005632:Fructose; D014635:Valproic Acid