Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms: With special reference to electroencephalographic changes

Fumika Endoh, Katsuhiro Kobayashi, Yumiko Hayashi, Takashi Shibata, Harumi Yoshinaga, Yoko Ohtsuka

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES. Methods: Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤12 years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings. Results: The median age at the start of TPM treatment was 5 years, 8 months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥50% reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated. Conclusions: TPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects.

Original languageEnglish
Pages (from-to)522-528
Number of pages7
JournalSeizure
Volume21
Issue number7
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Generalized Epilepsy
Spasm
Seizures
Electroencephalography
Therapeutics
topiramate
Anorexia
Epilepsy

Keywords

  • Children
  • Electroencephalogram
  • Epileptic spasms
  • Intractable epilepsy
  • Topiramate

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms : With special reference to electroencephalographic changes. / Endoh, Fumika; Kobayashi, Katsuhiro; Hayashi, Yumiko; Shibata, Takashi; Yoshinaga, Harumi; Ohtsuka, Yoko.

In: Seizure, Vol. 21, No. 7, 09.2012, p. 522-528.

Research output: Contribution to journalArticle

@article{738d1da2e45f464bac7a2d855061b29a,
title = "Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms: With special reference to electroencephalographic changes",
abstract = "Purpose: Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES. Methods: Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤12 years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings. Results: The median age at the start of TPM treatment was 5 years, 8 months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥50{\%} reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated. Conclusions: TPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects.",
keywords = "Children, Electroencephalogram, Epileptic spasms, Intractable epilepsy, Topiramate",
author = "Fumika Endoh and Katsuhiro Kobayashi and Yumiko Hayashi and Takashi Shibata and Harumi Yoshinaga and Yoko Ohtsuka",
year = "2012",
month = "9",
doi = "10.1016/j.seizure.2012.05.009",
language = "English",
volume = "21",
pages = "522--528",
journal = "Seizure : the journal of the British Epilepsy Association",
issn = "1059-1311",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms

T2 - With special reference to electroencephalographic changes

AU - Endoh, Fumika

AU - Kobayashi, Katsuhiro

AU - Hayashi, Yumiko

AU - Shibata, Takashi

AU - Yoshinaga, Harumi

AU - Ohtsuka, Yoko

PY - 2012/9

Y1 - 2012/9

N2 - Purpose: Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES. Methods: Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤12 years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings. Results: The median age at the start of TPM treatment was 5 years, 8 months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥50% reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated. Conclusions: TPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects.

AB - Purpose: Epileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES. Methods: Out of 58 children with ES, we enrolled 33 patients treated with TPM at ≤12 years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings. Results: The median age at the start of TPM treatment was 5 years, 8 months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥50% reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated. Conclusions: TPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects.

KW - Children

KW - Electroencephalogram

KW - Epileptic spasms

KW - Intractable epilepsy

KW - Topiramate

UR - http://www.scopus.com/inward/record.url?scp=84863987601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863987601&partnerID=8YFLogxK

U2 - 10.1016/j.seizure.2012.05.009

DO - 10.1016/j.seizure.2012.05.009

M3 - Article

C2 - 22698380

AN - SCOPUS:84863987601

VL - 21

SP - 522

EP - 528

JO - Seizure : the journal of the British Epilepsy Association

JF - Seizure : the journal of the British Epilepsy Association

SN - 1059-1311

IS - 7

ER -