Topiramate in the therapy of Lennox-Gastaut Syndrome
Wang Yi,
Sun Daokai, Chen Tianlan, Qiu Penglin
Children's Hospital of Fudan University, Shanghai,
China
Objective: To evaluate the efficacy and adverse effects of topiramate (TPM) as
add-on therapy and mono-therapy for Lennox-Gastaut Syndrome (LGS) in
pediatric patients.
Methods: 47
patients were diagnosed to be LGS by clinic history and EEG findings. 34
patients with intractable seizures and 13 patients with newly diagnosed
were treated as add-on or mono-therapy with TPM.
Results:
47 patients aged 2 months to 15 years old received TPM treatment at a mean
dose of 6.4±2.8 mg/kg.d for 3 to 15 months. Seizure
frequency reduced ³50% was 34.1%. 19/47 children became seizure
free. Within 13 children with TPM mono-therapy, 24.3% had a ³50% seizure frequency reduction, and 46.2%(6/13) with
seizure-free. Drop attacks, atypical absence, atonic and tonic were reduced³50% in 34%, 21.4%, 25% and 25% respectively; The mean
changes in plasma concentration of concomitant AEDs from baseline phase to
TPM treatment phase did not differ significantly. The common adverse events
were somnolence (10/47), dyspepsia (9/17), alalia (3/47), hypophrasia
(5/47), no sweating (4/47) and unbalance (1/47). 3 children discontinued TPM
therapy because of appetite loss and weight decrease.
Conclusions: TPM adjunctive or mono- therapy is effective in drop
attacks, atypical absence, atonic and tonic seizures and is well-tolerated
in children with LGS.