拉莫三嗪对新诊断成人原发性癫痫患者生活质量的影响

目的探讨拉莫三嗪(LTG)治疗新诊断成人原发性癫痫的临床疗效。方法选择符合标准的癫痫患者40例,采用LTG单药治疗,观察记录治疗前后癫痫发作次数及成人癫痫患者生活质量量表-31(QOLIE-31)评分。结果控制16例(40.0%),显效14例(35.00%),有效8例(20.00%),无效2例(5.00%)。治疗后患者QOLIE-31各维度评分较治疗前均提高,差异有统计学意义(P0.05)。癫痫发作频率减少百分率与QOLIE-31总评分呈显著正相关关系(r=0.350,P0.05)。结论 LTG治疗新诊断成人原发性癫痫具有较高的癫痫发作控制率,临床疗效显著,可以明显改善患者的生存状态和生活质量。     

拉莫三嗪对癫痫患者脑电图的影响

目的观察拉莫三嗪对癫痫患者脑电活动的影响。方法选取我院神经内科门诊及住院部明确诊断为癫痫的患者63例,予拉莫三嗪治疗,用药前及用药3个月、6个月时行脑电图(EEG)检查,观察患者用药前后EEG痫性放电及脑电背景方面的变化。结果与用药前比较,用药3个月及6个月时EEG痫样放电明显减少,差异有统计学意义(P0.05)。脑电图背景活动α波频率、θ波及δ波个数与用药前相比无明显变化,差异无统计学意义(P0.05)。结论应用拉莫三嗪可使癫痫患者EEG痫性放电明显减少,对脑电背景活动影响较小,从而为临床癫痫用药提供电生理学依据。     

拉莫三嗪对癫癎患者生活质量影响的研究

目的:评价拉莫三嗪对癫癎患者生活质量的影响.方法: 采用多中心、前瞻性的研究方法,对新诊断癫癎患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOS SF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价.结果: 共纳入新诊断癫癎患者282例.MOS SF-36量表的8个项目得分在用药后均有显著提高(P<0.01);QOLIE-31问卷中"对癫癎的担心","情绪"、"活力","认知","药物不良反应"、"社会功能"及"总体自身健康评价"项目得分在用药后均有显著提高(P<0.01).用药后,患者Hamilton抑郁量表平均3.65分,显著低干基线期6.42分(P<0.01);数字符号转换测验得分在用药后与基线期比较有显著提高(P<0.01).结论: 拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫癎患者的生活质量.     

拉莫三嗪治疗顽固性癫痫的临床观察

对３０例顽固性癫痫病人进行拉莫三嗪开放添加剂治疗。为期三个月。以后仍服用，剂量１００－４００ｍｇ／ｄ３０例患者总的癫痫发作次数减少４６％，１３％完全控制。拉莫三嗪对控制各类癫痫发作均有效，总显效率达６７％，不良反应较少，主要是变态反应性皮疹，停药后消失，实验室检查完全正常。     

添加拉莫三嗪治疗难治性癫痫

采用保持原用抗病药物及剂量不变，添加拉莫三嗪（LTG）治疗161例难治性痛痛患者。以治疗前3个月的发作次数为基础，与治疗期间3个月内发作次数比较，结果显示：添加LTG后癫痫发作完全控制者12例，占7．45％；明显好转者69例，占42．8％。其中全身强直-阵挛发作者疗效最佳，其明显好转者为48．52％，部分性发作者中明显好转者为44％。Lennox－Gastaut综合征8例，明显好转者50％。该药副作用小，减量或停药后症状消失。     

拉莫三嗪对癫(癎)患者认知功能与生活质量的影响

目的 评价拉莫三嗪对癫(癎)患者认知功能以及生活质量的影响.方法 对91例新诊断的癫(癎)患者给予拉莫三嗪治疗,并在用药前及用药16周后进行认知功能评定及生活质量调查.认知功能评定工具包括听觉词语测验、逻辑记忆测验、数字符号转换测验、Stroop字色干扰测验、连线测验、言语流畅性测验、韦氏积木测验、数字广度测验及Boston命名测验;生活质量调查采用患者生活质量评定量表-31(QOLIE-31).结果 癫(癎)患者应用拉莫三嗪治疗16周后与用药前比较,各项得分均有提高,其中以即刻与延迟词语记忆、情景记忆、执行功能、空间知觉能力以及言语命名功能方面改善显著.生活质量方面,QOLIE-31量表的7个测评方面及1个总体健康评价中,6项分值在用药后较用药前有所提高,其中"对癫(癎)的担心"(38.81±16.06,16周后45.68±15.18,P＜0.01)、"总体生活质量"(59.12±13.50,16周后64.99±13.33,P＜0.01)、"社会功能"(64.59±25.14,16周后69.41±22.70,P＜0.05)以及"总体自身健康评价"(71.18±13.73,16周后76.75±11.30,P＜0.01)4项的得分差异有统计学意义.结论 拉莫三嗪单药治疗新诊断癫(癎)患者可在短期内改善其认知功能,并提高生活质量.     

拉莫三嗪对新诊断成人癫癎患者生活质量的影响

随着健康定义的改变,医学模式也从单纯的生物医学模式转变为生物一心理一社会医学模式。因此,癫癎治疗及康复的目的不再局限于发作的控制和症状的缓解,而是使患者的健康状况全面改善或恢复。本研究采用两个量表调查拉英三囔（LTG）对新诊断成人癫癎患者生活质量的影响。探讨和发现影响生活质量的因素,对于采取多方面的综合治疗措施,为提高成人癫癎患者生活质量提供理论依据。     

拉莫三嗪对癫痫患者认知功能影响的研究

癫痫是神经系统常见病之一,口服抗癫痫药是癫痫治疗的首选方法,药物在控制痫性发作的同时其对认知功能的影响愈来愈受到人们的关注,选择既能够控制癫痫发作又不影响患者认知功能的抗癫痫药物成为提高癫痫患者生活质量的关键所在。     

拉莫三嗪对新诊断成人癫患者生活质量的影响

随着健康定义的改变,医学模式也从单纯的生物医学模式转变为生物-心理-社会医学模式。因此,癫治疗及康复的目的不再局限于发作的控制和症状的缓解,而是使患者的健康状况全面改善或恢复。本研究采用两个量表调查拉莫三嗪(LTG)对新诊断成人癫患者生活质量的影响。探讨     

癫痫患者的生活质量及其评定工具

生活质量应能反映多维的健康状况,至少包括由疾病或治疗引起的生理、心理和社会效应。相关的生活质量评定工具通常分为一般(不针对特定的年龄、疾病或治疗组)和特异(针对特定的症状、疾病或与治疗相关的患者的情况)两种。理想的生活质量评定工具应满足正确性、使用的广泛性和量表内容的特异性。同时满足这3个要求的有WPSI,ESI-55,QOLIE,LiverpoolBatteries等,研究癫患者生活质量时可作为首选。另外SF-36,改良SEALS等满足其中两个要求,可根据需要选用,因为可与对照组比较,预计将来会得到更广泛的应用。其他的生活质量评定工具,都推荐作为次选。我们也建议同时使用一般和癫特异生活质量量表。     

左乙拉西坦添加治疗对难治性部分性癫(癎)患者生活质量影响的研究

目的:评价新型抗癫药物左乙拉西坦(Lev)作为添加治疗对难治性部分性癫患者生活质量的影响。方法:43例确诊有癫部分性发作的成年患者随机分为两组:Lev治疗组与安慰剂组,Lev治疗16周后比较两组的有效率和不良反应,并用QOLIE-31量表对两组癫患者进行生活质量评定,所有患者在转入Lev开放性治疗6个月后再次进行QOLIE评估。结果:16周治疗期末Lev组癫部分性发作的治疗有效率明显高于安慰剂组,两组不良反应的发生率相当;Lev组生活质量明显高于安慰剂组,两组患者转入开放性治疗6个月后,生活质量均显著改善。结论:Lev作为添加用药治疗成人难治性部分性癫发作,显著减少发作频率、安全耐受性较好,能够提高癫患者的生活质量。     

Lamotrigine: clinical experience in 93 patients with epilepsy

This open study reports the use of lamotrigine in 93 adults and children with drug resistant epilepsy. Lamotrigine was used predominantly as add-on therapy and outcome was assessed by the patient, parents and carers and the physician in terms of reduction of seizure frequency, drug side effects, and importantly with this drug, improvement in quality of life. Twenty five of the 93 patients (26.9%) studied were rendered seizure free with the addition of lamotrigine to their therapy. This was especially the case for patients with complex partial seizures, generalised seizures secondary to brain damage, primary generalised epilepsy and the Lennox Gastaut syndrome. Quality of life improvements were especially striking in patients with seizures secondary to brain damage and in the Lennox Gastaut Syndrome. Twenty eight patients ceased lamotrigine, 13 due to lack of effect and the remainder due to side effects. Lamotrigine is a potentially very useful anti-epileptic medication in persons with complex partial seizures, but also in primary generalised epilepsy, the Lennox Gastaut syndrome and especially in those individuals who have seizures subsequent to brain damage.     

Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy

Background and PurposeThis study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters.MethodsAmong 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t-tests. Multiple linear regression analyses were also performed to determine how the patients'' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment.ResultsAfter VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline.ConclusionsThis study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.     

成人癫痫患者生活质量评定研究进展

癫痫（EP）是一种常见的慢性神经系统疾病,EP的反复发作、长期服用抗癫痫药物（AEDs）、社会歧视等使患者的生活质量显著下降,成人EP患者生活质量受躯体、社会、心理等多方面因素的影响。有效控制患者的EP发作,尽量采用单药治疗、个体化用药及应用新型AEDs等,并提高EP患者的社会支持,从而提高EP患者的生活质量。     

Psychiatric Symptoms and Quality of Life in Patients with Drug-Refractory Epilepsy Receiving Adjunctive Levetiracetam Therapy

Background and Purpose

Levetiracetam (LEV) is a new antiepileptic drug that has been found to be effective as an adjunctive therapy for uncontrolled partial seizures. However, the results of several studies suggested that LEV has negative psychotropic effects, including irritability, aggressiveness, suicidality, and mood disorders. We investigated the impact of adjunctive LEV on psychiatric symptoms and quality of life (QOL) in patients with drug-refractory epilepsy (DRE) and determined the risk factors provoking psychiatric adverse events.

Methods

A 24-week, prospective, open-label study was conducted. At enrollment, we interviewed patients and reviewed their medical charts to collect demographic and clinical information. They were asked to complete self-report health questionnaires designed to measure various psychiatric symptoms and QOL at enrollment and 24 weeks later.

Results

Seventy-one patients were included in the study, 12 patients (16.9%) of whom discontinued LEV therapy due to serious adverse events including suicidality. The risk factor for premature withdrawal was a previous history of psychiatric diseases (odds ratio 4.59; 95% confidence interval, 1.22-17.32). LEV intake resulted in significant improvements in Beck Anxiety Inventory score (p<0.01) and some domains of the Symptom Checklist-90-Revised, such as somatization (p<0.05), obsessive-compulsiveness (p<0.05), depression (p<0.05), and anxiety (p<0.05). These improvements were not related to the occurrence of seizure freedom. The Quality of Life in Epilepsy Inventory-31 overall score and subscale scores, such as seizure worry (p<0.01), overall QOL (p<0.05), emotional well-being (p<0.05), energy-fatigue (p<0.05), and social function (p<0.05), also improved.

Conclusions

Adjunctive LEV in patients with DRE is likely to improve psychiatric symptoms and QOL. Clinicians should be well aware of the psychiatric histories of patients to prevent them from developing serious adverse events related to LEV.     

血药浓度监测对成人癫痫患者生活质量的影响

目的 观察血药浓度监测对成人癫痫患生活质量的影响。方法 用前瞻性、自身对照的方法对长期服用抗癫痫药治疗效果不佳的成人癫痫患进行了血药浓度和生活质量的评定，观察其药物影响的特点。结果 (1)患组与对照组相比生活质量方面差别具有非常显性意义(P＜0．01)；(2)有效治疗浓度范围内急生活质量提高，差别有显性意义(P＜0．05)；(3)血药浓度与生活质量间具有显正相关(P＜0．01)。结论 成人癫痫患存在生活质量下降，合理用药、血药浓度监测可控制癫痫发作、提高患生活质量。     

育龄期女性癫痫患者社会心理及生活质量的研究

目的：研究女性癫痫患者社会心理及生活质量损害的特点及其影响因素。方法：对161例18-50岁女性（女性癫痫患者81例及健康女性80例）进行一般生活情况,疾病史及妇产科病史的调查。应用抗癫痫药物的不良反应量表,癫痫患者的生活质量-31项量表,焦虑自评量表,汉密尔顿抑郁量表,亚利桑那州女性性体验量表,进行社会心理和生活质量评定,比较其在癫痫患者与正常女性之间的差异并探索相关的影响因素。结果：女性癫痫患者存在广泛的社会心理及生活质量损害。女性患者在抑郁发生和性功能障碍与健康女性有明显差异。抑郁、性功能障碍、癫痫发作频率、抗癫痫药物的不良反应、个人收入、用药依从性是影响女性癫痂患者生活质量的重要因素。结论：育龄期女性癫痫患者需要更多的治疗和心理方面的关心指导,以利于提高其生活质量。