托吡酯通常被认为是治疗假性脑瘤综合征 (PTCS) 的二线药物，但评估其在儿童中的疗效的研究有限。对年龄 <21 岁的 PTCS 患者进行回顾性研究，这些患者单独使用托吡酯或单独使用托吡酯治疗与乙酰唑胺联合使用。记录有关临床过程和视力结果的数据。总共确定了 46 名患者。 3 名 (6.5%) 患者单独接受托吡酯治疗，31 名 (67.4%) 患者从乙酰唑胺转为托吡酯，12 名 (26.1%) 患者同时服用托吡酯和乙酰唑胺。托吡酯治疗视乳头水肿的中位时间为 0.57 年（四分位距为 0.32 至 0.84）。在托吡酯开始治疗时，根据 Frisen 量表分级的视乳头水肿眼中，57 只眼中的 40 只 (70.2%) 为 1 级，57 只眼中的 9 只 (15.8%) 为 2 级，57 只眼中的 8 只 (14.0%) 为 3 级。 27 例46 名 (58.7%) 的患者报告服用托吡酯后头痛有所改善。托吡酯的平均剂量为 1.3 ± 0.8 mg/kg/天。最常见的副作用是患者报告认知速度减慢（46 例中有 10 例 [21.7%]）。所有接受托吡酯单药治疗且符合治疗和随访的患者视乳头水肿均得到缓解，且无视功能丧失的证据。托吡酯可有效治疗轻至中度视乳头水肿或无法耐受乙酰唑胺的儿童的 PTCS。需要更多的研究来评估托吡酯治疗更严重视乳头水肿的功效。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Topiramate is often considered as a second-line medication for the treatment of pseudotumor cerebri syndrome (PTCS), but limited studies exist that evaluate its efficacy in children.Retrospective study of patients aged <21 years with PTCS who were treated with topiramate alone or in combination with acetazolamide was performed. Data regarding clinical courses and visual outcomes were recorded.A total of 46 patients were identified. Three (6.5%) patients were treated with topiramate alone, 31 (67.4%) transitioned to topiramate from acetazolamide, and 12 (26.1%) took both topiramate and acetazolamide concurrently. The median time to resolution of papilledema on topiramate was 0.57 years (interquartile range 0.32 to 0.84). Among eyes with papilledema graded on the Frisen scale at topiramate initiation, 40 of 57 (70.2%) were grade 1, nine of 57 (15.8%) were grade 2, and eight of 57 (14.0%) were grade 3. Twenty-seven of 46 (58.7%) reported headache improvement after starting topiramate. The mean dose of topiramate was 1.3 ± 0.8 mg/kg/day. The most common side effect was patient report of cognitive slowing (10 of 46 [21.7%]). All patients on topiramate monotherapy who were compliant with treatment and follow-up had resolution of papilledema with no evidence of visual function loss.Topiramate can effectively treat PTCS in children with mild to moderate papilledema or in those unable to tolerate acetazolamide. More research is needed to assess the efficacy of topiramate for higher grade papilledema.Copyright © 2024 Elsevier Inc. All rights reserved.