Wang Y, Zhou D, Pauli E, Stefan H
Sino-German Epilepsy Center, Department of Neurology, First University Hospital, West China University of Medical Sciences, 610041 Chengdu, Sichuan, People's Republic of China.
Epilepsy Res. 2001 Sep;46(3):271-7. doi: 10.1016/s0920-1211(01)00283-2.
Intensive and quantitative evaluation of the severity and frequency of seizures and ictal signs during topiramate (TPM) treatment.
Twenty patients with refractory partial seizures undergoing presurgical evaluation were randomized into a low dosage (100 mg daily) and a parallel medium dosage (200 mg daily) group of TPM add-on medication. Study phases included a 3-day baseline video-EEG phase, a 10-day TPM titration phase without video-EEG and a 3-day TPM dose maintenance phase with video-EEG. During the baseline and the dose maintenance phase seizures were recorded using video-EEG monitoring and the following parameters were measured: duration (lasting seconds of each seizure and ictal sign), intensity (on a 0-3 scale), N/24 h (numbers of attacks per 24 h), D/24 h (duration per 24 h) of both seizures and defined ictal signs.
A total of 399 seizures during the baseline phase and the dose maintenance phase were intensively analyzed. Intergroup comparison suggested that duration, N/24 h and D/24 h of all seizures decreased more in the medium dosage group computing the reduction from baseline to the dose maintenance phase (P<0.05). There were statistically more significant reductions in the duration, intensity and N/24 h of ictal signs like hypermotoric movements, fumbling and vocalization in the medium dosage group (P<0.05).
Topiramate has an early dose-dependent effect on ictal seizures.
The present study intensively analyzed the duration, intensity, N/24 h and D/24 h of ictal seizure manifestations. The quantitative data suggested that topiramate had an early effect on ictal phenomena like ictal hypermotoric movements, fumbling and vocalization (P<0.05); effects were more prominent in the medium dosage group (200 mg daily) than the low dosage group (100 mg daily).
对托吡酯（TPM）治疗期间癫痫发作的严重程度和频率以及发作期体征进行深入定量评估。
20例接受术前评估的难治性部分性癫痫患者被随机分为低剂量（每日100毫克）和与之平行的中等剂量（每日200毫克）TPM添加药物治疗组。研究阶段包括为期3天的基线视频脑电图阶段、为期10天无视频脑电图的TPM滴定阶段以及为期3天有视频脑电图的TPM剂量维持阶段。在基线期和剂量维持期，通过视频脑电图监测记录癫痫发作情况，并测量以下参数：持续时间（每次癫痫发作和发作期体征持续的秒数）、强度（0 - 3级）、癫痫发作和明确的发作期体征的N/24小时（每24小时发作次数）、D/24小时（每24小时的持续时间）。
对基线期和剂量维持期的总共399次癫痫发作进行了深入分析。组间比较表明，从中等剂量组基线期到剂量维持期计算，所有癫痫发作的持续时间、N/24小时和D/24小时下降幅度更大（P<0.05）。中等剂量组发作期体征如多动、摸索和发声的持续时间、强度和N/24小时的降低在统计学上更显著（P<0.05）。
托吡酯对发作期癫痫发作有早期剂量依赖性作用。
本研究深入分析了发作期癫痫发作表现的持续时间、强度、N/24小时和D/24小时。定量数据表明，托吡酯对发作期现象如发作期多动、摸索和发声有早期作用（P<0.05）；在中等剂量组（每日200毫克）中作用比低剂量组（每日100毫克）更显著。
