小儿难治性癫痫62例药物治疗分析

目的评价抗癫痫药单药大剂量及联合用药治疗小儿难治性癫痫的疗效.方法在血药浓度监测下对54例患儿投予大剂量卡马西平(CBZ)或丙戊酸钠(VPA),无效者及呈混合类型发作者采取联合用药方式.结果单用CBZ者11%发作获完全控制,单用VPA者15%发作停止.这些患儿的血药浓度均已达到或超过有效浓度的上限.全组单药或联合用药共17例(27%)患儿获控制,16例(26%)发作减少50%以上.结论难治性癫痫患儿可以采用单药大剂量治疗及联合用药的方法,但应注意监测血药浓度,以避免发生中毒反应.

The drug treatment of 62 children with intractable epilepsy

Objective To evaluate the effectiveness of anti-epileptic drug monotherapy with large dosage and polytherapy in treatment of intractable epileptic children.Methods 54 patients received large doses of carbamazepine(CBZ)or valproate acid(VPA)under the monitoring serum concentrations.Those with no effect and with combined seizure types received polytherapy.Results Complete seizure control were observed in 11% and 15% of patients with CBZ and VPA treatment separately.Serum concentrations of both drug were in the upper therapeutic range or were above it.In our study seizure free were seen in 27% of patients and more than 50% reduction in seizure was found in 26% of patients.Conclusion The monotherapy with large dosage and polytherapy could be considered in intractable cases.But the monitoring of serum levels should be done to avoid over-dose reaction.