Efficacy and Safety of Topiramate as the First - Line Drug in the Treatment of Infantile Spasms

Objective Infantile 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 Methods In 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. Results Twenty 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. Conclusion Topiramate is an effective and safe drug in the treatment of IS and could beconsidered as the first line of treatment.