托吡酯治疗癫癎时出现的泌汗障碍的临床分析

目的 研究托吡酯(TPM)治疗中出现泌汗障碍的临床特征。方法 对TPM治疗癫癎239例中出现泌汗障碍的发生率、出现时间、临床特征、管理方法及预后进行研究。结果 ①泌汗障碍的发生率为15.1％(36/239),12岁及以下年龄组发生率为23.1％,12岁以上组为2.2％;②泌汗障碍表现为少汗,皮肤干燥,运动不能耐受、发热,夏季症状突出;③泌汗障碍多在加量期后期出现;④泌汗障碍症状较轻,多为暂时性,一般无需停药,但宜减缓加量速度或减少用药量,改善周围环境温度,避免剧烈运动。⑤解热药无助于发汗,停用TPM后泌汗障碍症状可消失。结论 与TPM相关的泌汗障碍均为全身性,年龄为泌汗障碍发生的相关因素。

Clinical analysis of hypohidrosis in epileptic patients receiving topiramate treatment

Objective To investigate the correlation between hypohidrosis and topiramate (TPM) treatment in epileptic patients. Methods 239 epileptic patients taking TPM as monotherapy were included. Morbidity, clinical features, medication, and prognosis of hypohidrosis were studied. Results 15.1% (36/239) children developed hypohidrosis, 23.1% (34/147) in people under 12 years and 2.2% (2/92) over 14 years respectively. The clinical including hypohidrosis, skin dryness, fever and intolerance of exercise, tended to be mild or moderate and always occurred when the dosage of topiramate was increased. It's not necessary to withdraw topiramate, however, it's recommended to reduce the dosage. Improvement of the environment and avoidance of hard excercises helped to make the situation better. Antipyretics were useless. Conclusions Hypohidrosis correlated with TPM treatment and the symptom is generalized. It mostly appeals in people less than 12 years. Age was a factor that influences the incidence of hypohidrosis.