Yonsei Med J.  2006 Aug;47(4):498-504. 10.3349/ymj.2006.47.4.498.

Topiramate Monotherapy in Infantile Spasm

• Kwon YS
• Jun YH
• Hong YJ
• Son BK

• KMID: 1779499
• DOI: http://doi.org/10.3349/ymj.2006.47.4.498

Abstract

Infantile spasm is an age-related refractory epilepsy. Topiramate is a new anticonvulsant with multiple mechanisms of action, and it may be effective for treating pediatric epilepsies. To evaluate the efficacy and tolerability of first-line topiramate treatment for infantile spasm, 20 patients received topiramate monotherapy during this study. They were treated with an initial dose of 1mg/kg/day, with a progressive titration of 1 mg/kg a week until their spasms were controlled and a maximum dose of 12mg/kg/day was achieved. The evaluation of the treatment efficacy was based on the spasm frequency data that was obtained by the scalp and video-EEG, and by the parental count of spasm. Thirty percent of the subjects became spasm-free during the study. Six of 20 subjects (30%) had cessation of spasm and disappearance of hypsarrhythmia as seen via the video EEG; four (50%) of eight idiopathic patients had a response, whereas two (17%) of 12 patients with symptomatic infantile spasm responded. Seventy of the patients, including the spasm-free patients, had a reduction in their seizure frequency of more than 50%, and 10% of the patients had a reduction in their seizure frequency of less than 50%. The clusters of spasm frequency decreased from 10.6 +/- 8.5 to 3.5 +/- 1.4 clusters/day. Topiramate is effective and tolerated in those patients suffering from infantile spasm. Our results suggest that this drug should be considered as a new first-line drug for treating infantile spasm.

Keyword

Infantile spasm; topiramate; monotherapy

MeSH Terms

Treatment Outcome
Spasms, Infantile/*drug therapy
Male
Infant
Humans
Fructose/*analogs & derivatives/therapeutic use
Female
Electroencephalography
Child, Preschool
Anticonvulsants/*therapeutic use
Age of Onset

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