Topiramate loading for refractory status epilepticus in children.

Objective: To describe three cases of refractory status epilepticus (RSE) in children responsive to topiramate (TPM).

Methods: Patients with SE refractory to therapeutic doses of at least two antiepileptic medications were given TPM, 10 mg/kg/d, for 2 consecutive days, followed by maintenance doses of 5 mg/kg/d.

Results: This protocol has been used in three cases of RSE at our institution. In each case, SE was aborted within 21 h of the initial dose of TPM. Two patients avoided pharmacologic coma, and one was rapidly weaned from continuous benzodiazepine infusion.

Conclusions: Our experience indicates that TPM loading can be effective in the treatment of RSE in children.