Abstract
Objective : The aim of the present study was to investigate the efficacy of topiramate (TPM) for the treatment of neurosurgical disease with localization-related epilepsy. Methods : TPM was administered as an add-on drug for patients who presented refractory seizures despite trying two or three antiepileptic drugs. A total of 27 patients with refractory localization-related epilepsy were enrolled in the study. Results : TPM was administered for at least 12 months. Fourteen patients attained seizure free status, 2 patients had a reduction of seizure frequency of more than 50%. The remaining 11 patients discontinued TPM because of adverse effects or insufficient efficacy. Among the 16 patients whose seizures were well-controlled without adverse effects, 11 patients (63.8%) took TPM at a dosage of less than 100 mg/day a smaller than recommended amount. On the contrary, 11 patients who were intolerable to the adverse effects of TPM, such as headache, dizziness or fainting withdrew from TPM administration, in spite of careful initial titration from a small dose. Conclusions : Seizure control was achieved with a lower dose of TPM than recommended for neurosurgical patients with localization-related refractory epilepsy.
