Efficacy of topiramate in children with refractory status epilepticus.

Abstract:

PURPOSE:Status epilepticus (SE) is a life-threatening medical condition associated with significant morbidity and mortality that requires urgent medical intervention. Although several agents are available to treat SE, they occasionally fail to abort seizure activity. Topiramate (TPM) was anecdotally reported to be effective in adult patients with refractory SE. In this study, we evaluated the efficacy of TPM administered to children with this condition. METHODS:We retrospectively reviewed the pediatric SE database at the University of Michigan Medical Center and identified three children with refractory SE who were treated with TPM. Those children failed to respond to treatment with benzodiazepines, phenytoin, phenobarbital, midazolam, or pentobarbital. Additional treatment with TPM was administered by nasogastric tube. All patients were continuously monitored by 21-channel digital EEG machines, and the diagnosis of SE was made by a board-certified neurophysiologist. RESULTS:The ages of the three children were 4.5 months, 34 months, and 11 years. TPM was initiated at 2 mg/kg/day in two children and at 3 mg/kg/day in the third. The status was terminated in all three children within 24 h of maintenance therapy with TPM at 5-6 mg/kg/day. CONCLUSIONS:These results support the potential efficacy of TPM for children with refractory SE. Larger prospective series are needed to confirm those results.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Kahriman M,Minecan D,Kutluay E,Selwa L,Beydoun A

doi

10.1046/j.1528-1157.2003.11803.x

subject

Has Abstract

pub_date

2003-10-01 00:00:00

pages

1353-6

issue

10

eissn

0013-9580

issn

1528-1167

pii

11803

journal_volume

44

pub_type

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