Low-dose topiramate is effective in the treatment of infantile spasms.
BACKGROUND
Management of infantile spasms is difficult because current treatment regimens, including many anticonvulsants and hormones, are often ineffective. We conducted this study to determine the effective dose of topiramate (TPM) in Taiwanese children with infantile spasms.


METHODS
Fourteen patients with infantile spasms were given TPM at an initial dose of 12.5 mg/d, and the dose was raised by 12.5 mg every 2 approximately 3 days. If the seizure frequency did not decrease during the initial 2 weeks, the dose was raised more rapidly. Titration continued for < or = 12 weeks. Subjects were monitored by weekly visits to undergo titration.


RESULTS
The etiology of the infantile spasms included a cryptogenic group (n = 3) and a symptomatic group (n = 11). Overall, spasms in 5 patients (38%) were completely controlled. A > or = 50% reduction in spasms was observed in 11 (85%) of 13 subjects during stabilization, while one patient quit the treatment. The mean dose of TPM during stabilization was 7.35 +/- 4.9 mg/kg/d. Among these, 6 patients achieved seizure control and 3 were free of seizures at TPM doses of lower than 6 mg/kg/d.


CONCLUSIONS
Seizure control was achieved with lower doses of TPM therapy than suggested in previous studies.
Hsieh
Meng-Ying
MY
Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University Medical Collage, Taoyuan, Taiwan, ROC.
Lin
Kuang-Lin
KL
Wang
Huei-Shyong
HS
Chou
Min-Liang
ML
Hung
Po-Cheng
PC
Chang
Ming-Yu
MY
D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D013036:Spasms, Infantile / Q000188:drug therapy*; D000077236:Topiramate
D000077236:Topiramate; D005632:Fructose; D000324:Adrenocorticotropic Hormone