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Ann Child Neurol > Volume 22(2); 2014 > Article
Journal of the Korean Child Neurology Society 2014;22(2):72-76.
DOI: https://doi.org/10.26815/jkcns.2014.22.2.72    Published online June 30, 2014.
The Effectiveness and Tolerability of Topiramate and Lidocaine Add-on Therapy in Children with Refractory Status Epilepticus.
Bong Hwa Kang, Youngsoo Sohn, Jung Eun Kim, Su Kyeong Hwang, Soonhak Kwon
Department of Pediatrics, Kyungpook National University Children's Hospital, School of Medicine, Daegu, Korea. shkwon@knu.ac.kr
Abstract
PURPOSE
This study was aimed to compare the effectiveness and tolerability of topiramate add-on therapy versus lidocaine add-on therapy in children with refractory status epilepticus. METHODS: We performed a retrospective analysis of children with refractory status epilepticus who were hospitalized at Kyungpook National University Hospital during the period 2005 to 2012. We divided them into two groups, Group A (midazolam, MDZ, and Topiramate, TPM:11 patients) and Group B (midazolam and lidocaine, LDC:7 patients). Furthermore, they were sub-categorized according to children's sex, age, seizure duration, and seizure type. To comepare the effectiveness and tolerability between the two groups, we evaluated seizure freedom, >50% seizure reduction, adverse events and mortality rates, respectively. RESULTS: In MDZ/TPM group, average dosage of midazolam infusion was 10.8+/-6.8 mcg/kg/min, seizure freedom was achieved in 1 out of 11 patients (9%) and >50% seizure reduction was in 2 out of 11 patients (18%). On the other hand, in MDC/LDC group, average dosage of midazolam infusion is 11.3+/-5.2 mcg/kg/min, seizure freedom was achieved in 2 out of 7 patients (29%) and >50% seizure reduction was 3 out of 7 patients (43%). Aside from the promising effects, there was no significant difference between the two groups. CONCLUSION: In children with refractory status epilepticus, topiramate or lidocaine add-on therapy seemed to be effective and fairly tolerated and showed no serious adverse effects. Therefore they can be an alternative treatment option. However, further studies are required.
Key Words: Refractory status epilepticus, Midazolam, Topiramate, Lidocaine, Children


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