Kelly, K., Stephen, L. J., Sills, G. J. and Brodie, M. J. (2002) Topiramate in patients with learning disability and refractory epilepsy. Epilepsia, 43(4), pp. 399-402. (doi: 10.1046/j.1528-1157.2002.47401.x) (PMID:11952770)
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Abstract
Purpose: Management of seizures in learning disabled people is challenging. This prospective study explored the efficacy and tolerability of adjunctive topiramate (TPM) in patients with learning disability and refractory epilepsy attending a single centre. Methods: Sixty‐four patients (36 men, 28 women, aged 16–65 years) were begun on adjunctive TPM after a 3‐month prospective baseline on unchanged medication. Efficacy end points were reached when a consistent response was achieved over a 6‐month period at optimal TPM dosing. These were seizure freedom or ≥50% seizure reduction (responder). Appetite, behaviour, alertness, and sleep were assessed by caregivers throughout the study. Results: Sixteen (25%) patients became seizure free with adjunctive TPM. There were 29 (45%) responders. A further 10 (16%) patients experiencing a more modest improvement in seizure control continued on treatment at the behest of their family and/or caregivers. TPM was discontinued in the remaining nine (14%) patients, mainly because of side effects. Final TPM doses and plasma concentrations varied widely among the efficacy outcome groups. Many patients responding well to adjunctive TPM did so on ≤200 mg daily. Mean carer scores did not worsen with TPM therapy. Conclusions: TPM was effective as add‐on therapy in learning‐disabled people with difficult‐to‐control epilepsy. Seizure freedom is a realistic goal in this population.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Brodie, Professor Martin and Stephen, Dr Linda and Sills, Dr Graeme |
Authors: | Kelly, K., Stephen, L. J., Sills, G. J., and Brodie, M. J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Life Sciences College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Epilepsia |
Publisher: | Wiley |
ISSN: | 0013-9580 |
ISSN (Online): | 1528-1167 |
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