Topiramate in patients with juvenile myoclonic epilepsy.
BACKGROUND
Topiramate is a broad-spectrum agent effective against primarily generalized tonic-clonic seizures (PGTCS) as well as partial-onset seizures. Juvenile myoclonic epilepsy is one of the most common idiopathic generalized epilepsies, with most patients experiencing PGTCS.


OBJECTIVE
To evaluate topiramate as add-on therapy in patients with juvenile myoclonic epilepsy.


METHODS
Post-hoc analysis of a patient subset from 2 multicenter, double-blind, randomized, placebo-controlled, parallel-group trials.


METHODS
Eighteen centers in the United States; 10 centers in Europe; 1 center in Costa Rica (primary trials).


METHODS
A total of 22 patients with juvenile myoclonic epilepsy participating in placebo-controlled trials assessing topiramate (target dose, 400 mg/d in adults) in inadequately controlled PGTCS.


METHODS
Reduction of PGTCS.


RESULTS
A 50% or more reduction of PGTCS in 8 of 11 topiramate-treated patients (73%) and 2 of 11 placebo-treated patients (18%) (P = .03). Reductions in myoclonic, absence, and total generalized seizures were also observed, although topiramate vs placebo differences did not achieve statistical significance.


CONCLUSIONS
As a broad-spectrum agent, topiramate is an effective option for patients with juvenile myoclonic epilepsy.
Biton
Victor
V
Arkansas Epilepsy Program, Little Rock 72205, USA. vbiton@swbell.net
Bourgeois
Blaise F D
BF
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000188:drug therapy*; D000077236:Topiramate; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose