Topiramate for intractable childhood epilepsy

To better define the efficacy and tolerability of the new anticonvulsant to piramate in pediatric patients, the clinical courses of 49 children with, i ntractable seizures were monitored during topiramate therapy. The 80% of ch ildren who had complex partial seizures experienced better seizure control with topiramate than the 20% who had generalized seizures. Efficacy was gre atest with doses between 2.5 and 7.5 mg/kg/day. More than half the children on topiramate experienced adverse effects which could interfere with learn ing at school, but 20% demonstrated increased alertness or improved behavio r. Topiramate is effective and may be considered as part of the treatment p athway for complex partial seizures in children, although careful monitorin g of cognitive function is required.