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Efficacy of Topiramate in Children with Refractory Status Epilepticus
Author(s) -
Kahriman Mustafa,
Minecan Daniela,
Kutluay Ekrem,
Selwa Linda,
Beydoun Ahmad
Publication year - 2003
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2003.11803.x
Subject(s) - topiramate , status epilepticus , medicine , midazolam , phenobarbital , refractory (planetary science) , phenytoin , anesthesia , pediatrics , anticonvulsant , epilepsy , sedation , psychiatry , physics , astrobiology
Summary: 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.