目的　观察添加托吡酯对难治性癫的临床效果与副作用。方法　对 18例难治性癫患者 ,加用TPM后观察其发作频率并与加用前进行比较 ,计算总有效率。同时进行临床疗效和副作用观察。结果　病人加用托吡酯后总有效率为 5 0 % ,其中显效率达 2 2 2 % (3例未再发作 )。副反应以胃肠道反应及神经系统症状为主 ,发生率为 5 2 6%。结论　加用TPM治疗难治性癫安全有效。 Objective To observe the clinical effects and side effects of topiramate on refractory epilepsy. Methods 18 patients with refractory epilepsy were treated with TPM and the frequency of seizures was observed and compared with the pre-treatment to calculate the total effective rate. At the same time clinical efficacy and side effects observed. Results The total effective rate of topiramate in patients was 50%, and the effective rate was 22.2% (3 cases did not re-attack). Side effects of gastrointestinal reactions and neurological symptoms, the incidence was 52.6%. Conclusions Adding TPM to the treatment of refractory epilepsy is safe and effective.