Abstracts

Infantile spasm is an age-related refractory epilepsy. Topiramate(TPM) is a new anticonvulsant with multiple action mechanisms that may be effective in intractable epilepsies. We evaluate the efficacy and tolerability of first-line TPM treatment for newly diagnosed patients with infantile spasm. TPM was given at a dose of 1 mg/kg per day, with a progressive titration of 1 mg/kg a week until spasms were controlled, the maximal tolerated dose was reached, or the maximal dose of 12 mg/kg/day was achieved. Effectiveness was evaluated by scalp EEG and by parental interview about count of seizure frequency. We administered TPM as monotherapy to twenty patients with newly diagnosed infantile spasms. This study included 17 boys and 3 girls, ranging in age from 3 to 24 months (mean age, 11 months). Regarding the etiology, cryptogenic group was 40%, and symptomatic 60%. Six (30%) patients became seizure free, eight (40%) patients achieved a seizure reduction of [gt]50%, spasm frequency decreased from 10.6 [plusmn] 8.5 to 3.5 [plusmn] 1.4 spasms/day. Adverse effects during titration and stabilization included sleep disturbance, lethargy, irritability, rash, and oligohidrosis. TPM is effective and tolerated in patients with infantile spasm. Our results suggest that TPM may be considered a new first-line drug in infantile spasm.