Topiramate in the prophylactic treatment of migraine in children.

We present a prospective case series of 24 children diagnosed with migraine refractory to prophylactics and treated for 4 months with topiramate as the only prophylactic drug. At the final visit, the mean topiramate dose was 3.5 +/- 1.7 mg/kg/day. Nearly all patients (87.5%) reported a shorter duration of attacks, and the average pain intensity was rated as mild by 14 patients (58.3%). Eight (33.3%) patients had adverse events, none of which were serious. In our sample of pediatric patients, topiramate was effective for the prophylactic treatment of migraine in children. It was well tolerated at the doses used for titration and maintenance. Controlled trials are needed to verify the efficacy of topiramate for migraine in children.