Background: Topiramate shows excellent reduction in seizure rate and minimal adverse events. However, there is a significant difference about the optimal dose, duration of topiramate management. Thus, we conduct the multi-center retrospective survey to examine the practical using patterns of topiramate in the neurosurgical patients.Objective: This study is to investigate the actual using patterns and clinical effects of topiramate in patients with neurosurgical disease as antiepileptic drugs (AEDs) in 94 korean multi-centers. Patients and methods: A total of 7,152 patients who had taken topiramate for at least 3 months between August 2008 and February 2009 were eligible to participate in this study. We evaluated demographic data, primary diseases, duration of topiramate administration, initial and subsequent dosage adjustment, concomitant AEDs, the frequency of seizure reduction, and adverse events. Results: Topiramate was most commonly prescribed in stroke (38%), and the mean initial dosage was 65 mg/day, and the mean maintenance dosage was 105 mg/day. The mean duration of the initial dosage for topiramate administration was 24 days, and the mean duration of the maintenance dosage was 125 days, respectively. Among groups with prophylactic administration, 98% did not develop convulsion and among groups with therapeutic administration, 2% was ineffective to control seizure. After taking topiramate, 2% patients showed adverse events, that sensory aberration was the most common. Conclusion: These results suggest that topiramate prescribe widely in diverse neurosurgical disorders, and effective in reduction of seizure frequency, and does not cause serious adverse effects comparable with old AEDs.Abstracts / Journal of the Neurological Sciences 357 (2015) e142-e160 e150