Topiramate has been shown to be safe and effective in refractory partial epilepsy in children. Pharmacokinetic studies show that the clearance of topiramate is greater in children than in adults; therefore, higher doses may be needed in children than adults. It is generally well tolerated, except for cognitive dysfunction. Weight loss and the risk of renal stones can be significant in some cases. However, when compared with other anticonvulsant medications, topiramate has few serious idiosyncratic reactions such as rash, hematologic reactions, and hepatotoxicity. (J Child Neurol 2000;15:S3-S6).
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