Topiramate efficacy in treatment of children with West syndrome

Abstract

The aim of our study was to assess prospectively the efficacy and tolerability of topiramate in treatment of children with West syndrome. Furthermore, we analyzed the effectiveness of topiramate in relation to etiology. Nineteen patients with West syndrome, aged 4 to 12 months, who were treated at the Pediatric Clinic, University Hospital of Split, Croatia between 2003-2005 were evaluated. The most common etiology was hypoxic-ischemic encepalopathy, which was the cause of seizures in 10 patients, followed by developmental cortical anomalies in 3 cases. Tuberous sclerosis was found in 2 patients and a porencephalic cyst was established in 1 patient. One patient was diagnosed with Down’s syndrome and another with a metabolic disease. For 1 patient the etiology of West syndrome remained unknown. Ten patients out of 19 improved significantly with reduction of seizure frequency of 50-75%. In 5 patients the reduction of seizure frequency was over 75% and in 4 it was 25-50%. Topiramate is effective in the treatment of children younger than 12 months with West syndrome, especially in those with hypoxic-ischemic brain injury causing seizures.