丙戊酸和拉莫三嗪治疗儿童失神癫癎的临床研究

目的：评价丙戊酸和拉莫三嗪单药治疗儿童失神癫癎的临床疗效。方法：通过典型临床表现和视频脑电图（过度换气诱发实验阳性）确诊儿童失神癫癎，将患者进行随机开放对照分组研究。分别给予丙戊酸和拉莫三嗪单药治疗，随访1年，观察患者的发作控制情况，脑电图的改善以及不良反应。结果：共有48例入组，45例患者完成观察，其中丙戊酸治疗组23例，拉莫三嗪治疗组22例。丙戊酸组在服药12月时有17例实现无发作，其中15例脑电图无癎样放电。拉莫三嗪组在服药12个月时12例无发作（P＞0.05），其中6例脑电图无癎样放电（P＜0.05）。所有患者均未见严重不良反应。结论：丙戊酸和拉莫三嗪均为治疗儿童癫癎的安全有效药物；丙戊酸控制癎样放电可能优于拉莫三嗪。［中国当代儿科杂志，2009，11（8）：653-655］

Valproic acid versus lamotrigine as a monotherapy for absence epilepsy in children

Objective To compare the efficacy of valproic acid(VPA)and lamotrigine as a monotherapy for absence epilepsy in children.Methods A randomized,open-label design was used.Childhood absence epilepsy was diagnosed based on the presence of typical seizures and video-EEG findings.Eligible patients were randomly treated with VPA or lamotrigine.All patients were followed up for 12 months.Results Forty-five out of 48 eligible children completed the study.There were 23 children in the VPA group and 22 children in the lamotrigine group.Seventeen children were seizure-free in the VPA group 12 months after treatment.Fifteen out of the 17 children showed normal EEG(no epileptic-formed discharge).Twelve children were seizure-free in the lamotrigine group 12 months after treatment.The proportion showing normal EEG in the camotrigine group(6/22,27.3%)was significantly lower than that in the VPA group(15/23,65.2%)(P<0.05).Severe adverse effects were not found in both groups.Conclusions Both VPA and lamotrigine are safe and efficacious for treatment of absence seizures in children.VPA appears to be better than lamotrigine in tapering epileptic-formed discharge.