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Nervenheilkunde 2013; 32(04): 225-229
DOI: 10.1055/s-0038-1628504
Übersichtsartikel
Schattauer GmbH

Topiramat in der Behandlung des Status epilepticus

Topiramate in the treatment of status epilepticus
J. Rösche
1   Klinik und Poliklinik für Neurologie, Universität Rostock
,
I. Pohley
1   Klinik und Poliklinik für Neurologie, Universität Rostock
,
C. Kampf
1   Klinik und Poliklinik für Neurologie, Universität Rostock
,
R. Benecke
1   Klinik und Poliklinik für Neurologie, Universität Rostock
› Author Affiliations
Further Information

Publication History

Eingegangen am: 21 December 2012

angenommen am: 13 January 2013

Publication Date:
24 January 2018 (online)

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Zusammenfassung

In den neuen Leitlinien der Deutschen Gesellschaft für Neurologie wird als Medikament der weiteren Wahl zur Behandlung des fokalen konvulsiven und des non-konvulsiven Status epilepticus (SE) unter anderem auch Topiramat (TPM) vorgeschlagen. Ziel dieser Übersichtsarbeit ist es, die vorliegenden Daten zur Verwendung von TPM bei der Behandlung des SE zu sichten. Auf Einzelfallebene wurden 13 Behandlungsepisoden mit einer Erfolgsrate von 30,8% publiziert. In 12 Fallserien wurden zusammen 147 Behandlungsepisoden mit TPM beim SE beschrieben. TPM wurde in Dosen zwischen 50 mg und 1000 mg/Tag bereits zu Beginn der Behandlung angewandt. Dabei ergab sich auf der Basis der von den jeweiligen Autoren als sicheren Behandlungserfolg eingeschätzten Episoden ein Mittelwert der Erfolgsraten von 36,78%. Obwohl theoretisch gut begründet kann der Einsatz von Topiramat beim therapierefraktären Status epilepticus nur empfohlen werden, wenn etabliertere Substanzen entweder nicht zum Erfolg führten oder kontraindiziert sind.

Summary

In the latest version of the guidelines for the treatment of status epilepticus (SE) of the German Society of Neurology topiramate (TPM) is recommended for the treatment of focal convulsive and nonconvulsive SE when other treatment options have failed. In this paper we review the available clinical data concerning the treatment of SE with TPM. 13 single case reports with an efficacy rate of 30.8% were published. From 12 studies on the use of TPM in 147 treatment episodes of SE an efficacy rate of 36.78% can be estimated. The initial doses of TPM ranged between 50 mg and 1000 mg/day. In spite of good theoretical reasons for using TPM in the treatment of SE its use can only be recommended when established treatment options have failed or are contraindicated.

Schlüsselwörter

Status epilepticus - Topiramat - Erfolgskriterien

Keywords

Status epilepticus - topiramate - outcome criteria
 

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