title: Treatment of pediatric refractory status epilepticus with topiramate.
abstract: OBJECTIVE
  We evaluated a topiramate (TPM) regimen for treating refractory status epilepticus in the largest pediatric series, reported to date.
  
  
  METHODS
  Fourteen patients received TPM via the nasogastric route. Initially, all patients received TPM as a 5 mg/kg loading dose followed by 5 mg/kg/day in two doses as maintenance. Thereafter, patients were divided into three groups based on the response to TPM therapy and seizure cessation time (full responder, partial responder, and nonresponder). Four patients received only thiopental, two received thiopental, and high-dose midazolam, one received thiopental, high-dose midazolam, and propofol, two received only propofol, one received propofol, and high-dose midazolam and four patients were on a high-dose midazolam infusion.
  
  
  RESULTS
  The median time to seizure cessation was 5.5 h (range 2-48 h). Nine patients were full responders, three were partial responders, and two were nonresponders At follow-up, six patients were weaned successfully from thiopental, two patients from high-dose midazolam and three patients from propofol. Three patients developed mild metabolic acidosis during TPM theraphy.
  
  
  CONCLUSIONS
  Most of the patients responded to this treatment which was well tolerated. So we recommended its use for terminating refractory status epilepticus in children.
authors: Department of Pediatric Intensive Care, Erciyes University Faculty of Medicine, Talas Yolu, Melikgazi, Kayseri, Turkey. basaknurbesra@gmail.com
authors: Başak Nur
authors: BN
authors: Akyildiz
authors: Sefer
authors: S
authors: Kumandaş
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D013226:Status Epilepticus / Q000188:drug therapy*; D000077236:Topiramate; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose