Abstract

Objective Infantile Spasms (IS) is one of the catastrophic epileptic syndromes of infancy. The purpose of this study was to evaluate clinical efficacy and safety of topiramate (TPM) as the first -line drug in the treatment of infantile spasms. Materials and Methods In a quasi- experimental study, efficacy and safety of TPM in treatment of forty children with IS who were referred to pediatric neurology clinic of Shahid Sadoughi University of Medical Sciences in Yazd, Iran, from September 2008 to 2010 was evaluated. Results Twenty two girls (55) and 18 boys (45) with a mean age of 9.2 ± 3.9 months (range= 3-20 months) were evaluated. Ninety percent of the patients had symptomatic IS. At the end of three months of TPM treatment, 40 of the patients became seizure free, 27.5 had more than 50 reduction in seizure frequency, 27.5 had no notable change in seizure frequency and 5 had an increased frequency of seizures. Transient and mild side effects, which were seen in 32.5 of the patients, included drowsiness in 15, hypotonia and hyperthermia (each one) in 7.5 and anorexia and weight loss in 2.5. All side effects disappeared in two or three weeks of treatment. Conclusion Topiramate is an effective and safe drug in the treatment of IS and could be considered as the first line of treatment.