托吡酯治疗46例儿童癫痫的开放性研究

目的:探讨托吡酯(商品名:妥泰)单药和添加治疗儿童各型癫痫的临床疗效及不良反应。方法:总结我院1999年6月～2001年10月确诊癫痫患儿46例,其中部分性发作及部分继发全身性发作31例,全身强直一阵挛性发作3例,失神发作5例,Lennox-Gastaut综合征5例,Weast综合征2例,对已应用传统抗癫痫药物控制不理想的病例添加妥泰,而对新诊断病例应用单药治疗,均进行自身对照的开放性研究。结果:①妥泰治疗46例总有效率为84.8％,发作减少≥50％占2例(4.3％),发作减少≥75％占13例(28.2％),发作完全控制24例(52.1％)。②7例无效病例中5例失访,1例不良反应重退出,1例治疗恶化退出。③单药治疗37例,有效34例,总有效率91.9％,添加治疗9例,有效5例,总有效率55.5％,两者疗效比较,有显著性差异(P<0.05)。④不良反应:纳差、恶心22例(47.8％),反应差、记忆力下降15例(32.6％),嗜睡11例(23.9％),头晕、步态不稳4例(8.7％),体重下降4例(8.7％),多尿2例(4.4％),皮疹1例(2.2％)。结论:妥泰作为一种安全有效的新型抗癫痫药物,对于儿童各型癫痫发作均有明显疗效,且妥泰单药优于添加治疗,同时不良反应轻,可作为儿童癫痫的首选用药。

An open-labeled experience with topiramate in 46 children with epilepsy

Objective:To inversigate the efficacy and side-effect of topiramete as monotherapy and concomitant therapy in children with different kinds of epilepsy. Methods:An open-labeled and self-controlled study was conducted in 46 pediatic epilepsy treated by topiramate. Monterey was used in initiative patients and concomitant therapy was adopted in refractory epilepsy. Results: ①The frequently of all seizure was reduced ≥50%form baseline in 84. 4% of all patients with the treatment of topiramate, 2cases reuced 50%-74%,13cases reduced 75-99% and 24case were completely controlled. ②Seven case didn't have evident effect. Inthat 7 cases,5cases lost contact, I case quitted because of aggravating. ③Thirty-seven cases were treated by monotherapy. 34cases(91. 9%)had satisfied effect; 9cases were under the treatment of concomitant therapy;5cases(55. 5%)had evident effect.④Adverse reaction: dyspepsia and nausea occurred in 22 cases (47. 8%)Summer fever-like syndrome in 22cases(47. 8%). apathy and hypomnesia in 15 cases (32. 6%). Lethargy in 11 cases (23. 9%). dizziness and gait imbalance in 4 case (8. 7%). weight teduction in 4cases (8. 7%). polyproin 2 cases 4. 4%and rash in 1 case(2. 2%). Conclusion: Topiramate is a safety and efferent new anticon-vulsant druy, it produce a good curative effect to different kinds of.