291Original Article Low-Dose Topiramate Is Effective in the Treatment of Infantile Spasms

Background: Management of infantile spasms is difficult because current treatment regi-mens, including many anticonvulsants and hormones, are often ineffective. We conducted this study to determine the effective dose of topiramate (TPM) in Taiwanese children with infantile spasms. Methods: Fourteen patients with infantile spasms were given TPM at an initial dose of 12.5 mg/d, and the dose was raised by 12.5 mg every 2~3 days. If the seizure frequency did not decrease during the initial 2 weeks, the dose was raised more rapidly. Titration continued for ≤ 12 weeks. Subjects were monitored by weekly visits to undergo titration. Results: The etiology of the infantile spasms included a cryptogenic group (n = 3) and a symptomatic group (n = 11). Overall, spasms in 5 patients (38%) were completely controlled. A ≥ 50 % reduction in spasms was observed in 11 (85%) of 13 subjects during stabilization, while one patient quit the treat-ment. The mean dose of TPM during stabilization was 7.35 4.9 mg/kg/d. Among these, 6 patients achieved seizure control and 3 were free of seizure