title: Topiramate in the Treatment of Generalized Convulsive Status Epilepticus in Adults: A Systematic Review with Individual Patient Data Analysis.
abstract: BACKGROUND
  Generalized convulsive status epilepticus (GCSE) is a medical emergency associated with high morbidity and mortality that requires prompt medical intervention. Topiramate (TPM) is an antiepileptic drug effective against a broad spectrum of seizure types, and has been proposed as a possible therapeutic option for super-refractory status epilepticus (SRSE), the most severe form of GCSE.
  
  
  OBJECTIVE
  This review aimed to evaluate the role of TPM in GCSE, including SRSE.
  
  
  METHODS
  MEDLINE, CENTRAL, ClinicalTrials.gov, LILACS, Google Scholar, and Opengrey.eu were systematically searched. We compared: (1) patients who did and who did not receive TPM as their last drug; (2) patients receiving TPM as the last drug and achieving SE control and patients receiving TPM as the last drug but without termination of SE.
  
  
  RESULTS
  The literature search yielded 1164 results, with individual data available for 35 patients (six with SRSE) from four studies. SE was controlled in 68.6% of patients receiving TPM either as the last drug (20) or not (15), and in 14 of the 20 patients receiving TPM as the last drug (70%). Only six patients received TPM for SRSE; in five of them, TPM was administered as the last drug with resolution of SE in four. When comparing patients who did and did not receive TPM as the last drug, no statistically significant difference was found for any of the variables considered; similarly, no difference was found comparing patients receiving TPM as the last drug and achieving SE control with those receiving TPM as the last drug but without termination of SE.
  
  
  CONCLUSIONS
  The lack of a statistically significant difference is likely to be due to the small sample size. In only a few patients was TPM used for SRSE. There is an unmet need for high-quality studies to evaluate the role of TPM in GCSE.
authors.affiliation: Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.|Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
authors.forename: Francesco
authors.identifier: http://orcid.org/0000-0003-0928-1577
authors.initials: F
authors.lastname: Brigo
authors.affiliation: Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy.|Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.
authors.forename: Nicola Luigi
authors.initials: NL
authors.lastname: Bragazzi
authors.affiliation: Department of Neuro-Psychiatry, Federal Teaching Hospital, Abakaliki, Ebonyi, Nigeria.
authors.forename: Stanley C
authors.initials: SC
authors.lastname: Igwe
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.|Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria.|Christian Doppler Medical Centre, Salzburg, Austria.|Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Nardone
authors.affiliation: Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria. e.trinka@salk.at.|Christian Doppler Medical Centre, Salzburg, Austria. e.trinka@salk.at.|Centre for Cognitive Neurosciences Salzburg, Salzburg, Austria. e.trinka@salk.at.|Department of Public Health, Health Services Research and HTA University for Medical Informatics and Health Technology, UMIT, Hall in Tirol, Austria. e.trinka@salk.at.
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D013226:Status Epilepticus / Q000188:drug therapy*; D000077236:Topiramate
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose