Background: Oral topiramate is a broad-spectrum antiepileptic drug. There is limited documented data
on its use in refractory convulsive and non-convulsive status epilepticus. Methods: A retrospective
study of the clinical characteristics and responses of patients diagnosed as status epilepticus treated
with topiramate at the Srinagarind Hospital, Khon Kaen University from 2001-2010. Results: There
were 8 patients included in this study, 6 patients were convulsive status epilepticus and 2 patients
were non-convulsive status epilepticus. The most common cause was stroke seen in 4 patients. Oral
topiramate successfully controlled status epilepticus in 7 out of 8 patients with no serious adverse
events. Of these 7 patients, status epilepticus was controlled after initial loading and re-loading of
oral topiramate in 3 and 4 patients, respectively. In two patients with hepatitis, oral topiramate was
successful after failure with benzodiazepine. The initial loading dose of topiramate in most cases was
400 mg with a maintenance dose of 100 mg/day.
Conclusion: Oral topiramate has the potential to treat both convulsive and non-convulsive status
epilepticus after failing the fi rst antiepileptic drug. Further study with larger number of patients is
needed to confi rm this.