Gaily E, Granström M L, Liukkonen E
Department of Child Neurology, Hospital for Children and Adolescents, University of Helsinki, Finland.
J Intellect Disabil Res. 1998 Dec;42 Suppl 1:41-5.
Oxcarbazepine is similar to carbamazepine in its mechanisms of action and antiepileptic efficacy, but has better tolerability and fewer interactions with other drugs. Very few data are available on the usefulness of oxcarbazepine in patients with intellectual disability and epilepsy. From January 1991 until October 1994, the present authors treated 40 patients with intellectual disability and epilepsy under the age of 18 years with oxcarbazepine. The mean age at onset of epilepsy was 12 months (range = 0-132 months). All patients had previously been intractable to antiepileptic drugs (including carbamazepine in 29 patients). The age at onset of oxcarbazepine therapy ranged from 0.8 to 17.1 years (mean = 6.2 years). Thirty-one patients (78%) received other antiepileptic drugs simultaneously with oxcarbazepine. The mean follow-up with oxcarbazepine treatment was 18.8 months. The mean maximum oxcarbazepine dose was 49 mg kg(-1) day(-1) (range = 21-86 mg kg(-1) day(-1). A reduction in seizures of at least 50% during oxcarbazepine treatment was observed in 14 out of 28 (50%) patients with localization-related epilepsy and in 5 out of 12 (42%) patients with generalized epilepsy. Efficacy was transient in three patients. An increase of atypical absences was observed in one child and an emergence of drop attacks in another. Side-effects were observed in 16 (40%) patients; in eight (20%), these lead to dose reduction or discontinuation. Oxcarbazepine appears to be an effective and well-tolerated drug for children and adolescents with intellectual disability and epilepsy.
奥卡西平在作用机制和抗癫痫疗效方面与卡马西平相似，但耐受性更好，与其他药物的相互作用更少。关于奥卡西平对智力残疾合并癫痫患者的有效性，现有数据非常少。从1991年1月至1994年10月，本文作者用奥卡西平治疗了40例18岁以下智力残疾合并癫痫的患者。癫痫发作的平均起始年龄为12个月（范围=0 - 132个月）。所有患者之前对抗癫痫药物均耐药（包括29例曾使用卡马西平）。开始奥卡西平治疗的年龄范围为0.8至17.1岁（平均=6.2岁）。31例患者（78%）在使用奥卡西平的同时还接受了其他抗癫痫药物治疗。奥卡西平治疗的平均随访时间为18.8个月。奥卡西平的平均最大剂量为49 mg·kg⁻¹·d⁻¹（范围=21 - 86 mg·kg⁻¹·d⁻¹）。在28例（50%）局灶性相关性癫痫患者中，有14例在奥卡西平治疗期间癫痫发作减少至少50%；在12例（42%）全身性癫痫患者中，有5例出现类似情况。3例患者的疗效是短暂的。在1名儿童中观察到非典型失神发作增加，在另1名儿童中出现了跌倒发作。16例（40%）患者出现了副作用；其中8例（20%）因副作用导致剂量减少或停药。奥卡西平似乎是一种对智力残疾合并癫痫的儿童和青少年有效且耐受性良好的药物。
