Topiramate for Prophylaxis of Basilar Migraine in Children and Adolescents
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- Category: Vol. 79, September 2011
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Topiramate for Prophylaxis of Basilar Migraine in Children and Adolescents,SAYED A. AMIN and WALEED R. ABOU SEREE
Abstract
Objective: The aim of this study is to assess the efficacy and safety of topiramate for prophylaxis of basilar type of migraine in children and adolescents.
Methods: A prospective outpatient dose comparison study of patients with BM as defined by the International Classifi-cation of Headache disorder (second edition) where patients with >!4 migraines/month were randomized to receive either 25mg or 75mg/day topiramate.
Results: Fifteen children (5 boys, 10 girls) completed the study (8 in the 25-mg group and 7 in the 75-mg group). During the prospective baseline, the mean headache frequency of the combined group “all migraines” per month was 4.5/month (25mg) and 4.8/month (75mg). Average duration of migraine was 5.5 hours (25mg) and 5.0 hours (75mg) and average mean pain (5-point faces scale) was 3.3 for both (25mg 75mg).
The reduction in median monthly migraine rate relative to baseline was 2.9 (64.4%) and 3.6 (75.0%) for the 25-mg and 75-mg topiramate-treated groups, respectively (p<.001).
The reduction in median monthly BM rate relative to baseline was 2.5 (74.24%) and 2.3 (82.8%) for the 25-mg and 75 mg topiramate-treated groups, respectively. The overall reduction in BM attacks reduced from 2.84/month to 0.59/ month (79.2%; p<.0042).
Overall, 86% of patients responded with a greater than 50% reduction in migraine frequency (100%, 25mg and 71%, 75mg). Mean reduction in migraine duration was 18 minutes (25mg) and 89 minutes (75mg). There was no significant difference in migraine severity between the 2 groups. There were no serious adverse events in both groups.
Conclusions: Preventive therapy with topiramate resulted in reducing the overall migraine frequency and the frequency of attacks of BM at both 25mg and 75mg doses relative to the historical baseline and prospective baseline periods. The 2 treatment groups resulted in comparable outcomes.