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Original Contribution
November 2005

Topiramate in Patients With Juvenile Myoclonic Epilepsy

Victor Biton, MD; Blaise F. D. Bourgeois, MD; YTC/YTCE Study Investigators
Author Affiliations

Author Affiliations: Arkansas Epilepsy Program, Little Rock (Dr Biton); and Children’s Hospital, Boston, Mass (Dr Bourgeois).

Arch Neurol. 2005;62(11):1705-1708. doi:10.1001/archneur.62.11.1705

Background  Topiramate is a broad-spectrum agent effective against primarily generalized tonic-clonic seizures (PGTCS) as well as partial-onset seizures. Juvenile myoclonic epilepsy is one of the most common idiopathic generalized epilepsies, with most patients experiencing PGTCS.

Objective  To evaluate topiramate as add-on therapy in patients with juvenile myoclonic epilepsy.

Design  Post-hoc analysis of a patient subset from 2 multicenter, double-blind, randomized, placebo-controlled, parallel-group trials.

Setting  Eighteen centers in the United States; 10 centers in Europe; 1 center in Costa Rica (primary trials).

Patients  A total of 22 patients with juvenile myoclonic epilepsy participating in placebo-controlled trials assessing topiramate (target dose, 400 mg/d in adults) in inadequately controlled PGTCS.

Main Outcome Measure  Reduction of PGTCS.

Results  A 50% or more reduction of PGTCS in 8 of 11 topiramate-treated patients (73%) and 2 of 11 placebo-treated patients (18%) (P = .03). Reductions in myoclonic, absence, and total generalized seizures were also observed, although topiramate vs placebo differences did not achieve statistical significance.

Conclusion  As a broad-spectrum agent, topiramate is an effective option for patients with juvenile myoclonic epilepsy.