奥卡西平治疗儿童癫痫导致脑电图恶化1例报告并文献分析(英文)

目的伴有中央颞区尖波的儿童良性癫痫(benign epilepsy of childhood with centro-temporal spikes,BECT)是儿童中常见的部分性癫痫,卡马西平、奥卡西平、丙戊酸钠等药物治疗有效。文中观察奥卡西平对伴有中央颞区尖波的儿童良性癫痫的治疗效果。方法回顾性报道1例神经系统影像学检查未发现异常的6岁部分性癫痫患儿。结果最初以奥卡西平治疗,其原有的癫痫症状很快被控制,但脑电图随访过程中发现该例新诊断为部分性癫痫患者在奥卡西平单药治疗过程中脑电图恶化。随后,奥卡西平逐渐减量,并换用丙戊酸钠。当丙戊酸钠加至0.5g/d,该患者无癫痫发作且常规脑电图正常。结论虽然奥卡西平被认为是比卡马西平和苯妥英更易耐受的治疗部分性癫痫的一线药物,但应认识到它可能诱发新的癫痫发作形式和加重脑电图的异常。

Aggravation of electroencephalographic features in an epileptic child treated by oxcarbazepine monotherapy: A case report and review of the literature

Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.