The use of topiramate in idiopathic infantile spasms

초록

The use of topiramate in idiopathic infantile spasms Rationale: Infantile spasm presents one of the most refractory types of an age-related, catastrophic childhood epilepsy syndrome. The aim of this study was to evaluate the efficacy and tolerability of treatment with topiramate for idiopathic infantile spasms. Methods: We reviewed the medical records of treatment with topiramate for all children with idiopathic infantile spasms between 2003 and 2008 at our institution. Topiramate were treated with an initial dose of 1 mg/kg/day, with a progressive titration of 1 mg/kg a week until their spasms were controlled and a maximum dose of 10 mg/kg/day was achieved. The evaluation of the treatment efficacy was based on the spasm frequency data that was obtained by EEG and by the parental count of spasm. Results: 11 children were included in this review. Age of onset of spasms ranged from 3 to 10months (mean 5.6 ± 2.5 months). Four of 11 patients (37%) became spasm free and disappearance of hypsarrhythmia as seen via EEG. Three of 11 patients (27%) achieved a seizure reduction of more than 50%. The spasm frequency decreased from 10.3 ± 7.3 to 3.9 ± 2.8 spasm/day. Mild adverse effects during treatment included rash, oligohidrosis, lethargy, irritability. Conclusion: Our results suggest that topiramate monotherapy should be considered as an option for treating idiopathic infantile spasms.