Effectiveness of dose-escalated topiramate monotherapy and add-on therapy in neurosurgery-related epilepsy: A prospective study.
Medicine (Baltimore)
; 99(52): e23771, 2020 Dec 24.
Article
em En
| MEDLINE
| ID: mdl-33350762
ABSTRACT
BACKGROUND:
Lesional and symptomatic causes of epilepsy are the most common neurological disorders of the brain. Topiramate effectively controls newly diagnosed epilepsy and refractory focal seizures, but high-dose topiramate does not improve seizure control. This study aimed to evaluate the clinical efficacy and safety of dose-escalated topiramate as first-line monotherapy and add-on therapy in patients with neurosurgery-related epilepsy. MATERIAL ANDMETHODS:
A total of 55 neurosurgical patients with epilepsy were divided into monotherapy and add-on therapy groups and both groups received topiramate via the dose-escalation method. The primary efficacy outcomes were seizure-free rate and seizure response rate. Adverse events and seizure frequency were recorded.RESULTS:
The seizure response rate in the first month of monotherapy was significantly better than that of add-on therapy (89% vs 65%, Pâ<â.05), but no significant differences were found in seizure response rates between the 2 groups after 2 months of treatment. Both monotherapy and add-on therapy were effective in controlling seizures, with mean seizure frequency of 0.725 vs 0.536 and seizure-free rate of 88% vs 78.6%. Both treatments showed good improvement of seizure frequency in patients without tumor. The efficacy of monotherapy was better than that of add-on therapy (80% vs 29.2%) in patients with body mass index (BMI) ≤24. However, add-on therapy was better than monotherapy (76.7% vs 21.4%) in patients with BMIâ>â24. Dizziness (25.5%) and headache (16.4%) were the most common adverse events. No severe adverse event such as cognitive impairment was observed.CONCLUSIONS:
Dose-escalated topiramate monotherapy and add-on therapy demonstrate good efficacy and safety, with fewer adverse events in seizure control in neurosurgical patients.
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Procedimentos Neurocirúrgicos
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Relação Dose-Resposta a Droga
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Quimioterapia Combinada
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Epilepsia
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Topiramato
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article