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Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği

Yıl 2010, Cilt: 8 Sayı: 2, 20 - 23, 01.09.2010

Öz

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

Kaynakça

  • 1. Brenner M, Oakley C, Lewis DW. Unusual headache syndromes in children. Curr Pain Headache Rep 2007;11:383-9.
  • 2. Hershey AD, Winner PK. Pediatric migraine: Recognition and treatment. J Am Osteopath Assoc 2005;105:2-8.
  • 3. Jan MM. Updated overview of pediatric headache and mig￾raine. Saudi Med J 2007;28:1324-9.
  • 4. Mortimer J, Ka J, Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using ad hoc, Valquist and IHS criteria. Dev Med Child Neurol 1992;34:1095-101.
  • 5. Headeache Classification Subcommittee of the International Headache Society. International classification of headache disorders (ICHD-II). Cephalalgia 2004;24:23-136.
  • 6. Gladstein J, Holden EW, Peralta L, Raven M. Diagnoses and symptom patterns in children preseting to a pediatric headache clinic. Headache 1993;33:497-500.
  • 7. Larsson BS. Somatic complaints and their relationship to depressive symptom in Swedish adolescents. J Child Psychol Psychiatry 1991;32:821-32.
  • 8. Powera SW, Gilman DK, Hershey AD. Headache and psychological functioning in children and adolescents. Headache 2006;46:1404-15.
  • 9. Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: the utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations (summary statement). Neurology 1994;44:1353-4.
  • 10. Abend NS, Younkin D. Medical causes of headache in children. Curr Pain Headache Rep 2007;11:401-7.
  • 11. Cvengros JA, Harper D, Shevell M. Pediatric headache: an examination of process variables in treament. J Child Neurol 2007;22:1172-81.
  • 12. Brna PM. Dooley JM. Headache in the pediatric population. Semin Pediatr Neurol 2006;13:222-30.
  • 13. Winner P, Pearlman E, Linder S, Jordan D, Fisher A, Hulihan J. Topiramate for Migraine Prevention in Children: A Randomized, Double-Blind, Placebo-Controlled Trial. Headache 2005;45: 1304-12.
  • 14. Hershey AD, Powers SW, Vockell B, Lecates S, Kabbouche Ma, Maynard MK. Development of A Questionnaire to Assess Disability of Migraines in Children. Neurology 2001;57:2034-9.
  • 15. Siberstein SD, Neto W, Schmitt J, Jacobs D, fort he MIGR-001 Study Group. Topiramate in migraine prevention: Result of a large controlled trial. Arch Neurol 2004;61:490-5.
  • 16. Brandes JL, Saper JR, Diamond M, Couch JR, Lewis DW, Schmitt J. For the migr-002 study group. Topiramate for migraine prevention: A randomized controlled trial. Jama 2004;291:965-73.
  • 17. Diener HC, Hansen PT, Dahlof C, Lainez MJA, Sandrini G, Wang SJ et al. For the m›gr-003 study group. Topiramate in migraine prophylaxis: Result from a placebo controlled trial with propranolol as an active control. J Neurol 2004;251:943-50.
  • 18. Hershey A, Powers S, Vockell A, Le Cates S, Kabbouche M. Effectiveness of topiramate in prevention of childhood headaches. Headache 2002;42:810-8.
  • 19. Phillipps TM, Bates SD, Rudnicki SA. Prophylaxis of pediatric headache with topiramate. Neurology 2003;60:444.
  • 20. Winner P, Jacobs D, Schmitt J. Topiramate for migraine prevention in adolescent patients. Presented at: Annual meeting of the American Academy of Neurology, 2004 april 24-may 1, San Francisco, California (poster p02.102)
  • 21. Sönmez M. Epilepsi Tedavisinde ‹laç Seçimi; Yeni Antikonvülsan ‹laçlar. Güncel Pediatri 2008;1:37-40.
  • 22. Diener Hc, Agosti R, Allais G, Bergmans P, Bussone G, Davies B et al. Cessation versus continuation of 6 month migraine preventive therapy with topiramate (PROMPT): A randomised, double-blind, placebo-controlled trial. Lancet Neurol 2007;6:1054-62.
  • 23. Mathew N, Kailasam J, Meadors L. Prophylaxis of migraine, transformed migraine and cluster headache with topiramate. Headache 2002;42:796-803.
  • 24. Borzy J, Koch T, Schimschock J. Effectiveness of topirama￾te in the treatment of pediatric chronic daily headache. Pediatr Neurol 2005;33:314-6.
  • 25. Ferreira J, Garcia N, Pedreira L. Topiramate in pediatric and adolescent migraine patients: A retrospective analysis. Headache 2002;42:453.
  • 26. Lewis D, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache 2004;44:230-7.

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

Yıl 2010, Cilt: 8 Sayı: 2, 20 - 23, 01.09.2010

Öz

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

Kaynakça

  • 1. Brenner M, Oakley C, Lewis DW. Unusual headache syndromes in children. Curr Pain Headache Rep 2007;11:383-9.
  • 2. Hershey AD, Winner PK. Pediatric migraine: Recognition and treatment. J Am Osteopath Assoc 2005;105:2-8.
  • 3. Jan MM. Updated overview of pediatric headache and mig￾raine. Saudi Med J 2007;28:1324-9.
  • 4. Mortimer J, Ka J, Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using ad hoc, Valquist and IHS criteria. Dev Med Child Neurol 1992;34:1095-101.
  • 5. Headeache Classification Subcommittee of the International Headache Society. International classification of headache disorders (ICHD-II). Cephalalgia 2004;24:23-136.
  • 6. Gladstein J, Holden EW, Peralta L, Raven M. Diagnoses and symptom patterns in children preseting to a pediatric headache clinic. Headache 1993;33:497-500.
  • 7. Larsson BS. Somatic complaints and their relationship to depressive symptom in Swedish adolescents. J Child Psychol Psychiatry 1991;32:821-32.
  • 8. Powera SW, Gilman DK, Hershey AD. Headache and psychological functioning in children and adolescents. Headache 2006;46:1404-15.
  • 9. Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: the utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations (summary statement). Neurology 1994;44:1353-4.
  • 10. Abend NS, Younkin D. Medical causes of headache in children. Curr Pain Headache Rep 2007;11:401-7.
  • 11. Cvengros JA, Harper D, Shevell M. Pediatric headache: an examination of process variables in treament. J Child Neurol 2007;22:1172-81.
  • 12. Brna PM. Dooley JM. Headache in the pediatric population. Semin Pediatr Neurol 2006;13:222-30.
  • 13. Winner P, Pearlman E, Linder S, Jordan D, Fisher A, Hulihan J. Topiramate for Migraine Prevention in Children: A Randomized, Double-Blind, Placebo-Controlled Trial. Headache 2005;45: 1304-12.
  • 14. Hershey AD, Powers SW, Vockell B, Lecates S, Kabbouche Ma, Maynard MK. Development of A Questionnaire to Assess Disability of Migraines in Children. Neurology 2001;57:2034-9.
  • 15. Siberstein SD, Neto W, Schmitt J, Jacobs D, fort he MIGR-001 Study Group. Topiramate in migraine prevention: Result of a large controlled trial. Arch Neurol 2004;61:490-5.
  • 16. Brandes JL, Saper JR, Diamond M, Couch JR, Lewis DW, Schmitt J. For the migr-002 study group. Topiramate for migraine prevention: A randomized controlled trial. Jama 2004;291:965-73.
  • 17. Diener HC, Hansen PT, Dahlof C, Lainez MJA, Sandrini G, Wang SJ et al. For the m›gr-003 study group. Topiramate in migraine prophylaxis: Result from a placebo controlled trial with propranolol as an active control. J Neurol 2004;251:943-50.
  • 18. Hershey A, Powers S, Vockell A, Le Cates S, Kabbouche M. Effectiveness of topiramate in prevention of childhood headaches. Headache 2002;42:810-8.
  • 19. Phillipps TM, Bates SD, Rudnicki SA. Prophylaxis of pediatric headache with topiramate. Neurology 2003;60:444.
  • 20. Winner P, Jacobs D, Schmitt J. Topiramate for migraine prevention in adolescent patients. Presented at: Annual meeting of the American Academy of Neurology, 2004 april 24-may 1, San Francisco, California (poster p02.102)
  • 21. Sönmez M. Epilepsi Tedavisinde ‹laç Seçimi; Yeni Antikonvülsan ‹laçlar. Güncel Pediatri 2008;1:37-40.
  • 22. Diener Hc, Agosti R, Allais G, Bergmans P, Bussone G, Davies B et al. Cessation versus continuation of 6 month migraine preventive therapy with topiramate (PROMPT): A randomised, double-blind, placebo-controlled trial. Lancet Neurol 2007;6:1054-62.
  • 23. Mathew N, Kailasam J, Meadors L. Prophylaxis of migraine, transformed migraine and cluster headache with topiramate. Headache 2002;42:796-803.
  • 24. Borzy J, Koch T, Schimschock J. Effectiveness of topirama￾te in the treatment of pediatric chronic daily headache. Pediatr Neurol 2005;33:314-6.
  • 25. Ferreira J, Garcia N, Pedreira L. Topiramate in pediatric and adolescent migraine patients: A retrospective analysis. Headache 2002;42:453.
  • 26. Lewis D, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache 2004;44:230-7.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Adem Parlak Bu kişi benim

Aytuğ Dikililer Bu kişi benim

Ümit Aydoğan

Sebahattin Vurucu Bu kişi benim

Bülent Ünay Bu kişi benim

Rıdvan Akın Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 8 Sayı: 2

Kaynak Göster

APA Parlak, A., Dikililer, A., Aydoğan, Ü., Vurucu, S., vd. (2010). Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği. Güncel Pediatri, 8(2), 20-23.
AMA Parlak A, Dikililer A, Aydoğan Ü, Vurucu S, Ünay B, Akın R. Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği. Güncel Pediatri. Eylül 2010;8(2):20-23.
Chicago Parlak, Adem, Aytuğ Dikililer, Ümit Aydoğan, Sebahattin Vurucu, Bülent Ünay, ve Rıdvan Akın. “Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği Ve Güvenilirliği”. Güncel Pediatri 8, sy. 2 (Eylül 2010): 20-23.
EndNote Parlak A, Dikililer A, Aydoğan Ü, Vurucu S, Ünay B, Akın R (01 Eylül 2010) Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği. Güncel Pediatri 8 2 20–23.
IEEE A. Parlak, A. Dikililer, Ü. Aydoğan, S. Vurucu, B. Ünay, ve R. Akın, “Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği”, Güncel Pediatri, c. 8, sy. 2, ss. 20–23, 2010.
ISNAD Parlak, Adem vd. “Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği Ve Güvenilirliği”. Güncel Pediatri 8/2 (Eylül 2010), 20-23.
JAMA Parlak A, Dikililer A, Aydoğan Ü, Vurucu S, Ünay B, Akın R. Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği. Güncel Pediatri. 2010;8:20–23.
MLA Parlak, Adem vd. “Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği Ve Güvenilirliği”. Güncel Pediatri, c. 8, sy. 2, 2010, ss. 20-23.
Vancouver Parlak A, Dikililer A, Aydoğan Ü, Vurucu S, Ünay B, Akın R. Çocukluk Çağı Kronik Günlük Baş Ağrılarında Topiramat Tedavisinin Etkinliği ve Güvenilirliği. Güncel Pediatri. 2010;8(2):20-3.