Mullin Paul, Green Gary, Bakshi Rohit
Columbia University Comprehensive Epilepsy Center, New York Neurological Institute, 710 West 168th Street, New York, NY 10032, USA.
Curr Neurol Neurosci Rep. 2004 Jul;4(4):308-14. doi: 10.1007/s11910-004-0057-x.
An increasing percentage of patients with new-onset seizures are HIV positive. The evaluation and management is distinctly different from managing the non-HIV-infected patient. Clinicians must be familiar with comorbid infectious etiologies and the relative value of electroencephalogram, imaging, and serum and cerebrospinal fluid laboratory tests. Traditional antiepileptic drug (AED) therapies are contraindicated and may lead to increased HIV viral replication through either directed cellular mechanisms or interference with antiretroviral therapies. Newer AEDs have pharmacokinetic properties that make them reasonable choices, although none have been specifically studied for efficacy or safety in HIV. Lastly, optimal choice of an AED should reflect commonly encountered neurologic and psychiatric comorbidities.
新发癫痫患者中HIV阳性的比例日益增加。其评估和管理与非HIV感染患者明显不同。临床医生必须熟悉合并感染病因以及脑电图、影像学、血清和脑脊液实验室检查的相对价值。传统抗癫痫药物（AED）治疗是禁忌的，可能通过直接的细胞机制或干扰抗逆转录病毒治疗导致HIV病毒复制增加。新型AED具有药代动力学特性，使其成为合理选择，尽管尚未针对HIV患者的疗效或安全性进行专门研究。最后，AED的最佳选择应考虑常见的神经和精神合并症。
