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Year : 2003  |  Volume : 49  |  Issue : 3  |  Page : 202-206

Topiramate in the Treatment of Myoclonic-Astatic Epilepsy in Children: A Retrospective Hospital Audit

Department of Childhood Health, Paediatric Neurology Service, University Hospital of Wales, Cardiff, CF14 4XW and Janssen-Cilag Ltd., Saunderton, High Wycombe, Buckinghamshire HP14 4HJ, United Kindom

Correspondence Address:
S E Libretto
Janssen-Cilag Ltd., Saunderton, High Wycombe, Buckinghamshire HP14 4HJ
United Kindom
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Source of Support: None, Conflict of Interest: None

PMID: 14597780

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BACKGROUND: Myoclonic-Astatic Epilepsy (MAE) usually starts before five years of age and is associated with very frequent seizures and is highly resistant to treatment. AIM: To investigate the outcome of adjunctive topiramate (TPM) therapy in children with a diagnosis of MAE syndrome. Subjects AND METHODS: In an outpatient setting, case notes of 27 children who received TPM were retrieved and analysed. RESULTS: Records of 6 children with MAE, who were experiencing 2-8 atonic seizures daily before starting TPM were studied. Improvement was noted after addition of TPM (mean dose at steady-state 7.4±2.5mg/kg/day) to the regimen of 1-3 anti-epileptic drugs they were receiving concurrently. All but one child improved following the titration period: one had 50-80% improvement in the frequency of atonic seizures and three had over 80% improvement. However, one child who showed over 80% improvement and was free of atonic seizures, later developed increased frequency of other seizure types. In one child there was no significant improvement. Improvement has been sustained for over 6 months in three patients and over 4 months in one; three have continued TPM. TPM was stopped in three patients (reduction in seizure control/no improvement). CONCLUSIONS: This study supports the efficacy of TPM in controlling atonic seizures in MAE and indicates that it should be considered as an add-on drug in the management of this ‘difficult-to-treat’ epileptic syndrome.


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Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
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