Abstracts

Topiramate (TPM) is a newer antiepileptic medication available in the United States for the treatment of epilepsy since 1996. It is indicated as adjunctive therapy for adults and pediatric patients ages 2-16 years with partial onset seizures, or primary generalized tonic-clonic seizures, and in patients 2 years of age and older with seizures associated with Lennox-Gastaut syndrome. The purpose of this study was to review our clinical experience with TPM in an adult population. We retrospectively analyzed the charts of 12 adults with a variety of epileptic syndromes who had been on prior therapy and had an EEG while on TPM from Jan 2003 to Dec 2004. Ages ranged from 22 to 56 years. Demographics, seizure types, previous antiepileptic drugs (AEDs), dosages, concomitant AEDs, adverse events and outcome were recorded. Twelve patients were included; five men and seven women. Eight had partial onset epilepsy, and four primary generalized epilepsy. Associated disorders included mental retardation, renal failure, and history of meningitis. Patients were taking up to 3 AEDs when TPM was added. A [gt]50% seizure reduction was found in 8 patients (67%) Adverse events (AEs) included nephrolithiasis, behavioral difficulties, and parasthesias. Two patients experienced beneficial weight loss. Three patients discontinued treatment due to AEs. One patient undergoing hemodialysis required an additional dose with dialysis for adequate seizure control. Topiramate is an effective and well tolerated medication in the adult population for both partial onset and primary generalized epilepsy. Monotherapy is possible in both partial and generalized epilepsy patients. In this population studied all had difficult to control epilepsy and we were able to achieve significant improvement in 67% of our patients.