| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School (Dr. Sachdeo); Corporate Office Science and Technology (Dr. Reife), Johnson & Johnson, New Brunswick, NJ; The R.W. Johnson Pharmaceutical Research Institute (Drs. Lim and Pledger), Raritan, NJ; Department of Neurology, Children’s Hospital Medical Center (Dr. Glauser), Cincinnati, OH; and the Minnesota Epilepsy Group (Dr. Ritter), St. Paul, MN.
Address correspondence and reprint requests to Dr. Rajesh C. Sachdeo, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 97 Paterson Street, Room 118, New Brunswick, NJ 08903-0019.
OBJECTIVE: To evaluate the efficacy and safety of topiramate as adjunctive therapy for Lennox–Gastaut syndrome in a multicenter, double-blind, placebo-controlled trial.
BACKGROUND: Conventional antiepileptic drugs are frequently ineffective against multiple-seizure types of Lennox–Gastaut syndrome.
METHODS: Ninety-eight patients >1 year to <30 years of age, with slow spike-and-wave patterns on EEG, seizure types including drop attacks, and either a history of or active atypical absence seizures, were assigned to an 11-week, double-blind treatment phase with either topiramate or placebo. Topiramate was titrated to target doses of approximately 6 mg/kg/d.
RESULTS: For drop attacks, the most severe seizures associated with this syndrome, the median percentage reduction from baseline in average monthly seizure rate was 14.8% for the topiramate group and -5.1% (an increase) for the placebo group (p = 0.041). Topiramate-treated patients demonstrated greater improvement in seizure severity than did placebo-treated patients based on parental global evaluations (p = 0.037). The percentage of patients with a 
50% reduction from baseline in major seizures (drop attacks and tonic-clonic seizures) was greater in the topiramate group (15/46 or 33%) than in the control group (4/50 or 8%; p = 0.002). The most common adverse events in both groups were CNS related; there were no discontinuations from topiramate therapy due to adverse events.
CONCLUSIONS: Topiramate adjunctive therapy was effective in reducing the number of drop attacks and major motor seizures and in improving seizure severity as determined by parental global evaluation.
This article has been cited by other articles:
|
|
 |
|
  T. Glauser, G. Kluger, R. Sachdeo, G. Krauss, C. Perdomo, and S. Arroyo Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome Neurology, May 20, 2008; 70(21): 1950 - 1958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. F.D. Bourgeois Broader is better: The ranks of broad-spectrum antiepileptic drugs are growing Neurology, October 30, 2007; 69(18): 1734 - 1736. [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Glauser, D. J. Dlugos, W. E. Dodson, A. Grinspan, S. Wang, S.-C. Wu, and and the EPMN-106/INT-28 Investigators Topiramate Monotherapy in Newly Diagnosed Epilepsy in Children and Adolescents J Child Neurol, June 1, 2007; 22(6): 693 - 699. [Abstract] [PDF]
|
|
|
|
|
|
R. Korinthenberg and A. Schreiner Topiramate in Children With West Syndrome: A Retrospective Multicenter Evaluation of 100 Patients J Child Neurol, March 1, 2007; 22(3): 302 - 306. [Abstract] [PDF]
|
|
|
|
|
|
C. Chiron, S. Tonnelier, E. Rey, M.-L. Brunet, A. Tran, P. d'Athis, J. Vincent, O. Dulac, and G. Pons Stiripentol in Childhood Partial Epilepsy: Randomized Placebo-Controlled Trial with Enrichment and Withdrawal Design J Child Neurol, June 1, 2006; 21(6): 496 - 502. [Abstract] [PDF]
|
|
|
|
|
|
S. A. Hosain, S. Merchant, G. E. Solomon, and A. Chutorian Topiramate for the Treatment of Infantile Spasms J Child Neurol, January 1, 2006; 21(1): 17 - 19. [Abstract] [PDF]
|
|
|
|
 |
|
 V. Biton, B. F. D. Bourgeois, and for the YTC/YTCE Study Investigators Topiramate in Patients With Juvenile Myoclonic Epilepsy Arch Neurol, November 1, 2005; 62(11): 1705 - 1708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Kim, J. Aldridge, and J. M. Rho Clinical Experience With Zonisamide Monotherapy and Adjunctive Therapy in Children With Epilepsy at a Tertiary Care Referral Center J Child Neurol, March 1, 2005; 20(3): 212 - 219. [Abstract] [PDF]
|
|
|
|
|
|
R. Sankar Initial treatment of epilepsy with antiepileptic drugs: Pediatric issues Neurology, November 23, 2004; 63(10_suppl_4): S30 - S39. [Abstract] [Full Text]
|
|
|
|
|
|
T. A. Glauser Behavioral and Psychiatric Adverse Events Associated With Antiepileptic Drugs Commonly Used in Pediatric Patients J Child Neurol, August 1, 2004; 19(1_suppl): S25 - S38. [Abstract] [PDF]
|
|
|
|
|
|
W. D. Shields Management of Epilepsy in Mentally Retarded Children Using the Newer Antiepileptic Drugs, Vagus Nerve Stimulation, and Surgery J Child Neurol, August 1, 2004; 19(1_suppl): S58 - S64. [Abstract] [PDF]
|
|
|
|
|
|
J. A. French, A. M. Kanner, J. Bautista, B. Abou-Khalil, T. Browne, C. L. Harden, W. H. Theodore, C. Bazil, J. Stern, S. C. Schachter, et al. Efficacy and tolerability of the new antiepileptic drugs II: Treatment of refractory epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society Neurology, April 27, 2004; 62(8): 1261 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. LaRoche and S. L. Helmers The New Antiepileptic Drugs: Scientific Review JAMA, February 4, 2004; 291(5): 605 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Wheless, W. Neto, and S. Wang Topiramate, Carbamazepine, and Valproate Monotherapy: Double-Blind Comparison in Children With Newly Diagnosed Epilepsy J Child Neurol, February 1, 2004; 19(2): 135 - 141. [Abstract] [PDF]
|
|
|
|
|
|
T. A. Glauser Behavioral and Psychiatric Adverse Events Associated With Antiepileptic Drugs Commonly Used in Pediatric Patients J Child Neurol, January 1, 2004; 19(1_suppl): S25 - S38. [Abstract] [PDF]
|
|
|
|
|
|
W. D. Shields Management of Epilepsy in Mentally Retarded Children Using the Newer Antiepileptic Drugs, Vagus Nerve Stimulation, and Surgery J Child Neurol, January 1, 2004; 19(1_suppl): S58 - S64. [Abstract] [PDF]
|
|
|
|
|
|
D. K. Nguyen and S. S. Spencer Recent Advances in the Treatment of Epilepsy Arch Neurol, July 1, 2003; 60(7): 929 - 935. [Full Text] [PDF]
|
|
|
|
|
|
M. Mula, M. R. Trimble, P. Thompson, and J. W.A.S. Sander Topiramate and word-finding difficulties in patients with epilepsy Neurology, April 8, 2003; 60(7): 1104 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Watemberg, H. Goldberg-Stern, B. Ben-Zeev, I. Berger, R. Straussberg, S. Kivity, U. Kramer, N. Brand, and T. Lerman-Sagie Clinical Experience With Open-Label Topiramate Use in Infants Younger Than 2 Years of Age J Child Neurol, April 1, 2003; 18(4): 258 - 262. [Abstract] [PDF]
|
|
|
|
|
|
F.G. Gilliam, F. Veloso, M.A.M. Bomhof, S.K. Gazda, V. Biton, J.P. Ter Bruggen, W. Neto, C. Bailey, G. Pledger, and S.-C. Wu A dose-comparison trial of topiramate as monotherapy in recently diagnosed partial epilepsy Neurology, January 28, 2003; 60(2): 196 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Glauser Integrating clinical trial data into clinical practice Neurology, June 25, 2002; 58(12_suppl_7): S6 - S12. [Full Text]
|
|
|
|
|
|
P. K. Crumrine Antiepileptic Drug Selection in Pediatric Epilepsy J Child Neurol, February 1, 2002; 17(2_suppl): 2S2 - 2S8. [Abstract] [PDF]
|
|
|
|
|
|
E. Trevathan Infantile Spasms and Lennox-Gastaut Syndrome J Child Neurol, February 1, 2002; 17(2_suppl): 2S9 - 2S22. [Abstract] [PDF]
|
|
|
|
|
|
P. K. Crumrine Lennox-Gastaut Syndrome J Child Neurol, January 1, 2002; 17(1_suppl): S70 - S75. [Abstract] [PDF]
|
|
|
|
|
|
M. J. Schwabe and J. W. Wheless Clinical Experience With Topiramate Dosing and Serum Levels in Children 12 Years or Under With Epilepsy J Child Neurol, November 1, 2001; 16(11): 806 - 808. [Abstract] [PDF]
|
|
|
|
 |
|
 Managing childhood epilepsy DTB, February 1, 2001; 39(2): 12 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Glauser Topiramate in the Catastrophic Epilepsies of Childhood J Child Neurol, December 1, 2000; 15(1_suppl): S14 - S21. [Abstract] [PDF]
|
|
|
|
|
|
P. M. Levisohn Safety and Tolerability of Topiramate in Children J Child Neurol, December 1, 2000; 15(1_suppl): S22 - S26. [Abstract] [PDF]
|
|
|
|
|
|
B. F.D. Bourgeois Pharmacokinetics and Pharmacodynamics of Topiramate J Child Neurol, December 1, 2000; 15(1_suppl): S27 - S30. [Abstract] [PDF]
|
|
|
|
|
|
S.R. Snodgrass and B. R. Parks Anticonvulsant Blood Levels: Historical Review With a Pediatric Focus J Child Neurol, November 1, 2000; 15(11): 734 - 746. [Abstract] [PDF]
|
|
|
|
 |
|
 J. M. Pellock Managing Pediatric Epilepsy Syndromes With New Antiepileptic Drugs Pediatrics, November 1, 1999; 104(5): 1106 - 1116. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
