Mikati M A, Choueri R, Khurana D S, Riviello J, Helmers S, Holmes G
Department of Pediatrics, American University of Beirut, Lebanon.
J Intellect Disabil Res. 1998 Dec;42 Suppl 1:57-62.
Twenty-six children with intellectual disability and six normal children, all suffering from refractory partial seizures, received open-label gabapentin (range = 10-50 mg kg(-1) day(-1); mean = 26.7 mg kg(-1) day(-1) as an add-on medication to their antiepileptic drug regimen. Mean seizure frequency during baseline was 9.5 seizures per week. Both groups had a significant reduction in seizure frequency. Response scores and response ratios did not differ between the intellectually disabled and normal groups (1.67+/-0.67 and 1.25+/-0.69, P = 0.697, and -0.400+/-0.089 and -0.283+/-0.159, P = 0.961, respectively). Behavioural side-effects were more likely to occur in patients with intellectual disability in comparison with the mentally normal group (P = 0.0107). In the present patient population, patients younger than 10 years of age, all of whom had intellectual disability, were more likely to have side-effects than those older than 10 years of age. Observed adverse effects, which were generally mild, occurred in patients with baseline intellectual disability, attention deficit disorder and behavioural problems. Behavioural adverse effects warranted discontinuation of the medication in only three patients. The severity of intellectual disability (mild versus moderate or severe) did not affect the extent of the response or the occurrence of side-effects. It is concluded that gabapentin is equally effective as an add-on medication against partial seizures in patients with or without intellectual disability. However, children with intellectual disability who also are less than 10 years of age with baseline attention deficit appear to be at a higher risk of behavioural side-effects.
26名智障儿童和6名正常儿童，均患有难治性部分性癫痫发作，接受了开放标签的加巴喷丁治疗（剂量范围为10 - 50 mg·kg⁻¹·d⁻¹；平均剂量为26.7 mg·kg⁻¹·d⁻¹），作为其抗癫痫药物治疗方案的附加用药。基线期的平均癫痫发作频率为每周9.5次。两组的癫痫发作频率均显著降低。智障组和正常组的反应评分及反应率无差异（分别为1.67±0.67和1.25±0.69，P = 0.697；以及 - 0.400±0.089和 - 0.283±0.159，P = 0.961）。与智力正常组相比，智障患者更易出现行为副作用（P = 0.0107）。在本患者群体中，年龄小于10岁且均患有智障的患者比10岁以上患者更易出现副作用。观察到的不良反应一般较轻，发生在有基线智障、注意力缺陷障碍和行为问题的患者中。只有3名患者因行为不良反应而停药。智障的严重程度（轻度与中度或重度）并不影响反应程度或副作用的发生。结论是，加巴喷丁作为附加用药治疗部分性癫痫发作，对有无智障的患者同样有效。然而，伴有基线注意力缺陷且年龄小于10岁的智障儿童似乎发生行为副作用的风险更高。
