Prospective study of first-choice topiramate therapy in newly diagnosed infantile spasms.
OBJECTIVE
This was a prospective open study to establish the efficacy, tolerability, and problems associated with the use of topiramate as first-choice drug in children with infantile spasms.


METHODS
Open-label follow-up study, ranging from 24 to 36 months, of the cases of 54 patients with infantile spasms treated initially with topiramate as first-choice drug.


RESULTS
Thirty-one patients (57.4%) were seizure free for more than 24 months; 9 patients were treated with topiramate alone and 22 patients with topiramate plus nitrazepam and/or valproate. In 44 cases (81.4%), the reduction of seizure frequency from baseline was greater than 30%, whereas in 10 cases (18.6%), there was poor or no response. The average dosage applied was 5.2 mg/kg per day (maximum dosage, 26 mg/kg per day; minimum dosage, 1.56 mg/kg per day). Adverse events occurred in 14 patients (26%). They included poor appetite leading to anorexia, absence of sweating, and sleeplessness.


CONCLUSIONS
Topiramate proves to be an effective and safe first-choice drug not only as adjunctive but also as monotherapy of infantile spasms in children younger than 2 years.
Zou
Li-Ping
LP
Department of Neurology, Beijing Children's Hospital, Capital University of Medical Sciences, Beijing, China. zouliping21@hotmail.com
Ding
Chang-Huan
CH
Fang
Fang
F
Sin
Ngai-Chuen
NC
Mix
Eilhard
E
D000927:Anticonvulsants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004569:Electroencephalography / Q000379:methods; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000175:diagnosis / Q000188:drug therapy*; D000077236:Topiramate; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose