Topiramate: A broad spectrum antiepileptic drug, used in 224 patients with refractory epilepsy

Introduction. Topiramate (TPM) is a new antiepileptic drug with numerous mechanisms of action and whose references are almost entirely based on the results of clinical trials in selected patients. Objective. To assess the efficacy and tolerability of TPM under the usual conditions of everyday clinical practice, in a multicentric study of unselected patients with all types of uncontrolled epilepsy. Patients and methods. In 224 patients aged from 4 months to 85 years with uncontrolled epilepsy, we assessed the evolution of their seizures and the appearance of adverse effects when TPM was given. Results. There was a response to treatment with TPM in 78% of the patients (reduction >50% of the frequency of seizures) and suppression of seizures in 25% of the cases. The patients responding to treatment with TPM (reduction >50% of their seizures) included 77% of the patients with partial epilepsy, 83% of those with Lennox-Gastaut syndrome, 79% with multifocal epilepsy, 54% with West's syndrome and 69% of those with other types of epilepsy. Similarly seizures ceased in 31, 13, 15, 15 and 38% of the patients respectively. Although 34% of the patients had adverse effects, suspension of the drug was only necessary in 5% of the cases. Conclusions. TPM is a broad-spectrum drug, effective in patients with all types of seizures and epileptic syndromes. It is well tolerated when introduced gradually.