Troupin A S, Ojemann L M, Dodrill C B
Epilepsia. 1976 Dec;17(4):403-14. doi: 10.1111/j.1528-1157.1976.tb04452.x.
Serum levels of mephenytoin (Mesantoin) and its metabolite nirvanol were correlated with effectiveness and side effects in 93 patients. Mean mephenytoin level was 8% of the combined mephenytoin plus nirvanol levels. "Total mephenytoin" level should be used clinically, as neither individual component is as well correlated with clinical phenomena. Serum levels of 25 to 40 mug/ml usually yield improvement in seizure control without discomfort, and three-quarters of patients had fewer seizures. Side effects frequently associated with phenytoin were absent, but drowsiness, an occasional rash, and a single, fatal case of aplastic anemia were found. Performance on psychological tests of cognitive-attentional skills showed a modest improvement during mephenytoin administration. The drug merits wider employment in refractory seizure problems, but vigilant follow-up is required.
对93例患者的血清美芬妥英（麦山妥英）及其代谢产物尼凡诺水平与疗效和副作用进行了相关性研究。美芬妥英平均水平为美芬妥英与尼凡诺水平之和的8%。临床上应使用“总美芬妥英”水平，因为单独任何一种成分与临床现象的相关性都不如它。血清水平为25至40微克/毫升时通常能在不引起不适的情况下改善癫痫控制，四分之三的患者癫痫发作减少。通常与苯妥英相关的副作用未出现，但发现有嗜睡、偶尔出现皮疹以及1例致命的再生障碍性贫血病例。认知注意力技能心理测试结果显示，服用美芬妥英期间有适度改善。该药在难治性癫痫问题上值得更广泛应用，但需要密切随访。
