2 research outputs found
Efficacy and Safety of Topiramate as the First - Line Drug in the Treatment of Infantile Spasms
ObjectiveInfantile Spasms (IS) is one of the catastrophic epileptic syndromes of infancy.The purpose of this study was to evaluate clinical efficacy and safety oftopiramate (TPM) as the first -line drug in the treatment of infantile spasms.Materials and MethodsIn a quasi- experimental study, efficacy and safety of TPM in rteatment of fortychildren with IS who were referred to pediatric neurology clinic of ShahidSadoughi University of Medical Sciences in Yazd, Iran, from September 2008to 2010 was evaluated.ResultsTwenty two girls (55%) and 18 boys (45%) with a mean age of 9.2 ± 3.9 months(range= 3-20 months) were evaluated. Ninety percent of the patients hadsymptomatic IS. At the end of three months of TPM treatment, 40% of thepatients became seizure free, 27.5% had more than 50% reduction in seizurefrequency, 27.5% had no notable change in seizure frequency and 5% had anincreased frequency of seizures.Transient and mild side effects, which were seen in 32.5% of the patients,included drowsiness in 15%, hypotonia and hyperthermia (each one) in 7.5%and anorexia and weight loss in 2.5%. All side effects disappeared in two orthree weeks of treatment.ConclusionTopiramate is an effective and safe drug in the treatment of IS and could beconsidered as the first line of treatment.Keywords: Infantile spasms; Topiramate; Epilepsy. Â
Randomised Clinical Efficacy Trial of Topiramate and Nitrazepam in Treatment of Infantile Spasms
How to Cite This Article: Fallah R, Salor F, Akhavan Karbasi S, Motaghipisheh H. Randomised Clinical Efficacy Trial of Topiramate and Nitrazepam in Treatment of Infantile Spasms. Iran J Child Neurol. 2014 Winter; 8(1):12-19.ObjectiveInfantile spasms (IS) are among the most catastrophic epileptic syndromes of infancy. The purpose of this study was to compare efficacy and safety of topiramate (TPM) and nitrazepam (NZP) as first-line drugs in the treatment ofIS.Materials & MethodsIn a parallel single-blinded randomized clinical trial, 50 patients with IS referred to Pediatric Neurology Clinic of Shahid Sadoughi University of Medical Sciences, Yazd, Iran, were evaluated from September 2008 to March 2010.Patients were randomly assigned to two groups to be treated with TPM or with NZP for 6 months. The primary endpoint was efficacy in cessation of all spasms or reduction of more than 50% in weekly seizure frequency, which was evaluatedbefore and 6 months after the drug use. Secondary outcome was clinical sideeffects of the drugs.ResultsTwenty boys (40%) and 30 girls (60%) with the mean age of 9.4±3.8 months were evaluated. Cessation of all spasms occurred in 12 (48%) infants in TPM group and 4(16%) in NZP group. Eight (32%) children in TPM group and 7 (28%) in NZP group had more than 50% reduction in spasms frequency. So,TPM was more effective. Side effects were seen in 32% of TPM and in 36% of NZP groups.ConclusionTopiramate is an effective and safe drug, which might be considered as the firstline drug for the treatment of ISs.References:Watemberg N. Infantile spasms: treatment challenges. Curr Treat Options Neurol 2012;14(4):322-31.Tsao CY. Current trends in the treatment of infantile spasms. Neuropsychiatr Dis Treat 2009;5:289-99.Sankar R, Koh S, Wu J, Menkes JH. Paroxysmal disorders. In: Menkes JH, Sarnat HB, Maria BL, editors Child Neurology,7th ed. Philadelphia: Lippincott; 2006.p. 877.Engel J Jr. International League against Epilepsy (ILAE). 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