Purpose: Status epilepticus (SE) is a life-threatening medical condition associated with significant morbidity and mortality that requires urgent medical intervention. Although several agents are available to treat SE, they occasionally fail to abort seizure activity. Topiramate (TPM) was anecdotally reported to be effective in adult patients with refractory SE. In this study, we evaluated the efficacy of TPM administered to children with this condition. Methods: We retrospectively reviewed the pediatric SE database at the University of Michigan Medical Center and identified three children with refractory SE who were treated with TPM. Those children failed to respond to treatment with benzodiazepines, phenytoin, phenobarbital, midazolam, or pentobarbital. Additional treatment with TPM was administered by nasogastric tube. All patients were continuously monitored by 21-channel digital EEG machines, and the diagnosis of SE was made by a board-certified neurophysiologist. Results: The ages of the three children were 4.5 months, 34 months, and 11 years. TPM was initiated at 2 mg/kg/day in two children and at 3 mg/kg/day in the third. The status was terminated in all three children within 24 h of maintenance therapy with TPM at 5–6 mg/kg/day. Conclusions: These results support the potential efficacy of TPM for children with refractory SE. Larger prospective series are needed to confirm those results.
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机译：目的：癫痫持续状态（SE）是威胁生命的医学疾病，与高发病率和高死亡率相关，需要紧急医疗干预。尽管有几种药物可以治疗SE，但它们有时仍无法中止癫痫发作活动。据报道托吡酯（TPM）在难治性SE患者中有效。在这项研究中，我们评估了向患有这种疾病的儿童服用TPM的疗效。方法：我们回顾性地回顾了密歇根大学医学中心的儿科SE数据库，确定了三名接受TPM治疗的难治性SE儿童。这些儿童对苯二氮卓类，苯妥英钠，苯巴比妥，咪达唑仑或戊巴比妥治疗无效。通过鼻胃管给予TPM额外治疗。所有患者均通过21通道数字脑电图机进行连续监测，并由董事会认证的神经生理学家对SE进行诊断。结果：三个孩子的年龄分别为4.5个月，34个月和11岁。 TPM在两名儿童中以2 mg / kg /天开始，而在第三名儿童中以3 mg / kg /天开始。所有三名儿童在维持治疗后24小时内接受5-6 mg / kg /天的TPM终止治疗。结论：这些结果支持TPM对难治性SE儿童的潜在疗效。需要更大的预期序列来确认这些结果。
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