Mauri-Llerda J A, Tejero-Juste C, Iñiguez C, Morales-Asín F
Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, San Juan Bosco, 15. E-Zaragoza 50009.
Rev Neurol. 2001;32(3):247-50.
To review the current treatment and usefulness of lamotrigine in absence seizures.
Absence seizures are classified amongst the generalized epilepsies. They are defined as a transient loss of consciousness of sudden onset and recovery characteristically associated with generalized spike-and-wave discharges on the EEG. In recent years, the epileptic syndromes associated with this type of seizure have been better defined, basically by means of video-EEG studies. The International League Against Epilepsy has recognized four epileptic syndromes with typical absences: absence-epilepsy of childhood, juvenile absence-epilepsy, juvenile myoclonic epilepsy and epilepsy with myoclonic absences. The classical treatment for this type of seizure was based on ethosuximide, or more often, sodium valproate. Sometimes both drugs together were necessary. Other useful drugs are the benzodiazepines such as clobazam.
We review studies of the efficacy and tolerance of lamotrigine in the treatment of absence seizures, one of the groups of seizures in which this drug has been shown to be most effective. Although studies comparing lamotrigine, valproate and ethosuximide are necessary, we emphasize the possibility that lamotrigine may be a drug of choice in absence seizures.
综述拉莫三嗪在失神发作治疗中的现状及效用。
失神发作归类于全身性癫痫。其定义为意识突然短暂丧失且恢复,特征性地与脑电图上的全身性棘慢波放电相关。近年来,主要通过视频脑电图研究,与这类发作相关的癫痫综合征已得到更好的界定。国际抗癫痫联盟已确认四种伴有典型失神的癫痫综合征:儿童失神癫痫、青少年失神癫痫、青少年肌阵挛癫痫和肌阵挛失神癫痫。这类发作的经典治疗基于乙琥胺,或更常用的丙戊酸钠。有时两种药物联用是必要的。其他有用的药物是苯二氮䓬类,如氯巴占。
我们综述了拉莫三嗪治疗失神发作的疗效和耐受性研究,失神发作是已证明该药最为有效的发作类型之一。尽管有必要开展比较拉莫三嗪、丙戊酸和乙琥胺的研究,但我们强调拉莫三嗪可能是失神发作治疗首选药物的可能性。