Knott C, Panayiotopoulos C P
Department of Clinical Neurophysiology and Epilepsy, St Thomas' Hospital, London, UK.
Seizure. 1992 Sep;1(3):167-72. doi: 10.1016/1059-1311(92)90020-2.
We report the effect of vigabatrin on seizure frequency in 13 severely drug-resistant patients with intractable complex partial seizures (CPS) with or without secondary generalization. Patients were followed for a 3-month period before vigabatrin administration to establish a 'baseline'. Six patients became seizure free for 2-3 weeks immediately after starting vigabatrin. In seven patients a transient (4-6 weeks) increase in seizures above baseline occurred, which was attenuated by vigabatrin dose increments. After 3 months, the mean baseline CPS frequency was reduced from 7.75 +/- 1.18 (median 8, range 2.6-16) to 2.77 +/- 0.7 (median 1, range 0-7). At 6 months a > 50% improvement remained in seven patients. After 12 or more months CPS frequency returned to baseline in four patients, improved (by 25-62.5%) in four and deteriorated in three. One patient who was seizure free lost control at 16 months. Other effects were drowsiness (3), weight increase (3), diarrhoea (1), depression (2) and mood elevation (2). Four patients discontinued vigabatrin; one because of severe depression, three owing to lack of efficacy. Three patients have undergone and two are awaiting neurosurgery for their epilepsy. Thus, CPS frequency progressively deteriorated toward baseline in all patients, however, secondary generalizations were abolished in four and reduced in two.
我们报告了氨己烯酸对13例患有难治性复杂部分性发作（CPS）且伴有或不伴有继发性全身性发作的严重耐药患者癫痫发作频率的影响。在给予氨己烯酸之前，对患者进行了为期3个月的随访以建立“基线”。6例患者在开始使用氨己烯酸后立即有2至3周无癫痫发作。7例患者癫痫发作出现短暂（4至6周）高于基线的增加，通过增加氨己烯酸剂量这种增加得以减轻。3个月后，平均基线CPS频率从7.75±1.18（中位数8，范围2.6 - 16）降至2.77±0.7（中位数1，范围0 - 7）。6个月时，7例患者仍有超过50%的改善。12个月或更长时间后，4例患者的CPS频率恢复到基线，4例患者改善（改善25% - 62.5%），3例患者病情恶化。1例无癫痫发作的患者在16个月时失去控制。其他影响包括嗜睡（3例）、体重增加（3例）、腹泻（1例）、抑郁（2例）和情绪高涨（2例）。4例患者停用了氨己烯酸；1例因严重抑郁，3例因缺乏疗效。3例患者已接受神经外科手术治疗癫痫，2例正在等待手术。因此，所有患者的CPS频率逐渐向基线恶化，然而，4例患者的继发性全身性发作消失，2例患者的继发性全身性发作减少。
