Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği

Year 2010, Volume: 8 Issue: 2, 20 - 23, 01.09.2010

Adem Parlak Aytuğ Dikililer Ümit Aydoğan , Sebahattin Vurucu Bülent Ünay Rıdvan Akın

Abstract

Giriş: Bu çalışmada kronik günlük baş ağrısı olan çocuklarda topiramat tedavisinin etkinlik ve güvenilirliği araştırıldı.Gereç ve Yöntem: Bu çalışma kronik günlük baş ağrısı tanısı alan 100 çocuk hasta üzerinde prospektif olarak yapıldı. Hastaların tedavi öncesinde Pediatric Migraine DisabilityAssesment PEDMİDAS skorları ve dereceleri belirlendi. Hastalara 1 mg/kg/gün dozunda akşam tek doz topiramat tedavisi başlandı. Tedavinin onuncu gününde ilaç dozu 2 mg/kg/güne yükseltildi. Tedavinin 3. ayında hastaların PEDMİDAS skorları ve dereceleri tekrar değerlendirilerek tedavi öncesi ile karşılaştırılıp, tedavinin etkinliği incelendi.Bulgular: Hastaların tedavi öncesi ve sonrası PEDMİDAS skor ortalamaları sırasıyla34,60±22,28, 12,77±12,20 olarak bulundu. Bu iki değer arasında istatistiksel olarak anlamlıbir fark vardı p< 0,001 . PEDMİDAS skorlarına göre hastaları gruplandırdığımızda tedavi öncesi hastaların %68’i grade 4, %23’ü grade 3, %6’sı grade 2, %3’u grade 1 grubu iken; tedavi sonrası yapılan PEDMİDAS skorlamasında bu oranlar %38,4 grade 4, %29,4 grade 3,%21,5 grade 2, %10,7 grade 1 olarak değişti. Ayrıca hastaların %8,8’inde n=6 unutkanlık, %5,8’inde n=4 kilo kaybı ortalama 250 g ve %4,4’ünde n=3 parestezi saptanmıştır. Sonuç: Bu çalışma çocukluk çağı kronik günlük baş ağrısı tedavisinde topiramatın güvenli, iyi tolere edilebilen ve düşük dozlarda kullanılabileceğini, diğer ilaçlara cevapalınamaması halinde tercih edilebilecek alternatif bir tedavi seçeneği olabileceğini göstermiştir

Keywords

Topiramat, etkinlik, güvenilirlik, çocukluk çağı, baş ağrısı

The Efficacy and Reliability of Topiramat Use in Chronic Daily Headache in Childhood

Abstract

Introduction: In this study, the effectiveness and safety of topiramate treatment inchildren with chronic daily headache were investigated.Materials and Method: This study was perfomed prospectively among 100 childrenwho were diagnosed with chronic daily headache. Before the treatment, PediatricMigraine Disability Assesment PEDMİDAS scores and grades of the patients weredetermined. Topiramate was given as 1 mg/kg/day then the dose was increased to 2 mg/kg/day at the tenth day of the treatment. At the third month, PEDMİDAS scoresand grades were redetermined and compared with the first one.Results: The PEDMİDAS scores of the patients before and after the treatment were found as 34.60±22.28, 12.77±12.2, respectively. There was a statistical difference between these two values p< 0.001 . When we group the patients according to the PEDMİDAS scores before the treatment 68% of the patients were grouped as grade 4,23% as grade 3, 6% as grade 2 and 3% as grade 1; then after the treatment these percentages changed as 38.4% for grade 4, 29.4% for grade 3, 21.5% for grade 2 and10.7% for grade1, respectively. Also forgetfulness in 8.8% n=6 of patients, weight loss average 250 grams in 5.8% n=4 and paresthesia in 4.4% n=3 were determined.Conclusions: This study has shown that topiramate is safe, well tolerable and can beused with low doses in the treatment of chronic daily headache in childhood and isan alternative treatment choice that can be used in case no answers with otherdrugs

Keywords

Topiramate, efficacy, reliability, childhood, headache

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