title: Prospective study of first-choice topiramate therapy in newly diagnosed infantile spasms.
abstract: 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.
authors.affiliation: Department of Neurology, Beijing Children's Hospital, Capital University of Medical Sciences, Beijing, China. zouliping21@hotmail.com
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Zou
authors.forename: Chang-Huan
authors.initials: CH
authors.lastname: Ding
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.forename: Ngai-Chuen
authors.initials: NC
authors.lastname: Sin
authors.forename: Eilhard
authors.initials: E
authors.lastname: Mix
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose