妥泰单药及添加治疗卒中后部分性发作癫痫46例临床分析

目的观察妥泰单药及添加治疗卒中后部分性发作癫痫的临床疗效及不良反应。方法46例患者随机分为2组,A组24例采用妥泰添加治疗,B组22例采用妥泰单药治疗。2组初始剂量均为25mg/d,每周增量25mg,最大剂量至200mg/d。维持治疗12周,记录发作情况及不良反应。结果A组总有效率及控制率分别为70.8%和20.8%,B组总有效率及控制率分别为81.8%和27.2%,2组疗效差异有显著性意义(P<0.05)。妥泰对卒中后各型部分性发作癫痫间的疗效差异无显著性意义(P>0.05)。2组主要不良反应均为体重减轻、嗜睡、恶心和找词困难。添加组不良反应多于单药组,2组比较差异有非常显著意义(P<0.01)。结论妥泰单药及添加治疗卒中后部分性发作癫痫具有良好的疗效,以前者为佳,不良反应为体重减轻、嗜睡、恶心和找词困难,添加组不良反应多于单药组。

Clinical analysis of topiramate in monotherapy and adjunctive therapy for post stroke partial seizure

Objective To observe the efficacy and adverse reaction of topiramate (TPM) for post stroke partial seizure in monotherapy and adjunctive therapy .Methods 24 patients with post stroke partial seizure in group A received TPM as adjunctive antiepileptic drugs (AEDs).22 patients in group B received TPM as monotherapy AEDs. The starting dose of TPM was 25 mg/d and the dose was increased weekly by 25 mg until 200 mg/d was reached, with a treatment course of 12 weeks. During the treatment course the onset of seizure and adverse reaction were recorded.Results The total effective rate and control rate in group A were 70.8% and 20.8%,which were 81.8% and 27.2% in group B respectively. There was a significant difference between the two groups (P<0.05).The efficacy of TPM on the three kinds of partial seizures had no significant difference (P>0.05).Main side effects in group A and B were weight decrease, somnolence, nausea and speech disorder, but the side effects of adjunctive therapy were more than those of monotherapy. There was a significant difference between the two groups (P<0.01).Conclusion TPM is effective in treating post stroke partial seizure not only in adjunctive therapy but also in monotheraphy. The main side effects are weight decrease,somnolence, nausea and speech disorder. The side effects of adjunctive therapy are more than those of monotherapy.