title: Assessing the value of topiramate in refractory status epilepticus.
abstract: OBJECTIVE
  The aim of this study was to assess factors associated with the use of topiramate (TPM) in refractory status epilepticus (RSE).
  
  
  METHODS
  We retrospectively reviewed RSE episodes over a 12-year period. Episodes treated with and without TPM were compared in terms of demographics, RSE characteristics, clinical course, and outcome in univariate and multivariate analyses. Subgroups defined by type of RSE were studied separately. Functional outcome was assessed with the modified Rankin Scale.
  
  
  RESULTS
  Among 71 episodes, 17 (23.9%) were treated with TPM and seizure control was achieved in all of these. The results of unadjusted comparisons suggested a use of TPM in younger and healthier patients who received more perseverant treatment indicated by a higher number of antiepileptic drugs applied. In multivariate analysis adjusting for RSE duration, however, these associations lost significance. Furthermore, TPM was not a predictor of successful RSE termination in neither the overall cohort, nor in the subgroup of complex-partial RSE.
  
  
  CONCLUSIONS
  After multivariate adjustment, no significant differences were observed between episodes treated with and without TPM in baseline characteristics, treatment, and outcome. Regarding the latter, this study does therefore not yield evidence for a particular efficacy of TPM in RSE.
authors.affiliation: Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: Dominik.Madzar@uk-erlangen.de.
authors.forename: Dominik
authors.initials: D
authors.lastname: Madžar
authors.affiliation: Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: Joji.Kuramatsu@uk-erlangen.de.
authors.forename: Joji B
authors.initials: JB
authors.lastname: Kuramatsu
authors.affiliation: Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: Stefan.Gerner@uk-erlangen.de.
authors.forename: Stefan T
authors.initials: ST
authors.lastname: Gerner
authors.affiliation: Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: Hagen.Huttner@uk-erlangen.de.
authors.forename: Hagen B
authors.initials: HB
authors.lastname: Huttner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000494:pharmacology*; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*; D000077236:Topiramate
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose
keywords: Antiepileptic drugs; Functional outcome; Refractory status epilepticus; Seizure termination; Topiramate