Han Seung-A, Yang Eu Jeen, Kong Younghwa, Joo Chan-Uhng, Kim Sun Jun
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
Korean J Pediatr. 2017 Jul;60(7):227-231. doi: 10.3345/kjp.2017.60.7.227. Epub 2017 Jul 31.
This study aimed to verify the safety of low-dose topiramate on language development in pediatric patients with migraine.
Thirty newly diagnosed pediatric patients with migraine who needed topiramate were enrolled and assessed twice with standard language tests, including the Test of Language Problem Solving Abilities (TOPs), Receptive and Expressive Vocabulary Test, Urimal Test of Articulation and Phonology, and computerized speech laboratory analysis. Data were collected before treatment, and topiramate as monotherapy was sustained for at least 3 months. The mean follow-up period was 4.3±2.7 months. The mean topiramate dosage was 0.9 mg/kg/day.
The patient's mean age was 144.1±42.3 months (male-to-female ratio, 9:21). The values of all the language parameters of the TOPs were not changed significantly after the topiramate treatment as follows: Determine cause, from 15.0±4.4 to 15.4±4.8 (>0.05); making inference, from 17.6±5.6 to 17.5±6.6 (>0.05); predicting, from 11.5±4.5 to 12.3±4.0 (>0.05); and total TOPs score, from 44.1± 13.4 to 45.3±13.6 (>0.05). The total mean length of utterance in words during the test decreased from 44.1±13.4 to 45.3±13.6 (<0.05). The Receptive and Expressive Vocabulary Test results decreased from 97.7±22.1 to 96.3±19.9 months, and from 81.8±23.4 to 82.3±25.4 months, respectively (>0.05). In the articulation and phonology validation in both groups, speech pitch and energy were not significant, and all the vowel test results showed no other significant values.
No significant difference was found in the language-speaking ability between the patients; however, the number of vocabularies used decreased. Therefore, topiramate should be used cautiously for children with migraine.
本研究旨在验证低剂量托吡酯对偏头痛儿科患者语言发育的安全性。
招募30名新诊断的需要托吡酯治疗的偏头痛儿科患者,使用标准语言测试进行两次评估,包括语言问题解决能力测试(TOPs)、接受性和表达性词汇测试、发音和语音的尿嘧啶测试以及计算机语音实验室分析。在治疗前收集数据,托吡酯单药治疗持续至少3个月。平均随访期为4.3±2.7个月。托吡酯的平均剂量为0.9mg/kg/天。
患者的平均年龄为144.1±42.3个月(男女比例为9:21)。托吡酯治疗后,TOPs所有语言参数的值均无显著变化,如下所示:确定原因,从15.0±4.4变为15.4±4.8(>0.05);进行推理,从17.6±5.6变为17.5±6.6(>0.05);预测,从11.5±4.5变为12.3±4.0(>0.05);TOPs总分,从44.1±13.4变为45.3±13.6(>0.05)。测试期间话语的平均总词长从44.1±13.4减少到45.3±13.6(<0.05)。接受性和表达性词汇测试结果分别从97.7±22.1个月降至96.3±19.9个月,从81.8±23.4个月降至82.3±25.4个月(>0.05)。在两组的发音和语音验证中,音高和能量不显著,所有元音测试结果均无其他显著值。
患者之间的语言表达能力未发现显著差异;然而,使用的词汇量减少。因此,偏头痛儿童使用托吡酯时应谨慎。