Neurology Medical News about topiramate, pediatric migraine, prophylaxis

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Efficacy and tolerability of topiramate in pediatric migraine
Pediatric Neurology , 08/11/09

Cruz MJ et al. – Findings show that topiramate is an effective, safe alternative for prophylaxis of pediatric migraine, with an acceptable risk/benefit maintenance dose of ≤2 mg/kg/day.

Methods

Retrospective review of records for 37 pts: 22 (60%) girls and 15 (40%) boys
Mean age, 14 yrs; range, 7.3–20.5 yrs), diagnosed with migraine without aura in 30 (81%), with aura in 4 pts (11%), and abdominal, ophthalmoplegic, and catamenial in 1 pt each
Mean follow–up: 12 ± 5 mo standard deviation (SD)
Clinical response qualified as excellent, good, no change, or worse

Results

Numbers of headaches/mo: 15 ± 7 SD prior to treatment vs 3 ± 3.4 SD after treatment
Excellent/good response (>50% migraine reduction): 28 patients (76%)
Adverse effects: 10 pts (27%)
Side effects more likely with >2 mg/kg/day
Mean dose for pts without adverse effects: 1.27 ± 0.7 mg/kg/day SD
Mean dose for pts with adverse effects: 2.8 ± 1.5 mg/kg/day SD

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