Maschio M, Dinapoli L, Zarabla A, Pompili A, Carapella C M, Pace A, Giannarelli D, Occhipinti E, Jandolo B
Epilepsy Outpatient Center, Department of Neuroscience and Cervical-Facial Pathology, National Institute for Cancer Regina Elena, Via Elio Chianesi 53, Roma, 00144, Italy.
J Neurooncol. 2008 Jan;86(1):61-70. doi: 10.1007/s11060-007-9430-3. Epub 2007 Jun 28.
Epilepsy in brain tumor patients is often refractory to pharmacological treatments and can complicate the therapeutic management of these patients. We conducted a prospective, observational study. The aim of this study was to investigate the efficacy and tolerability of topiramate (TPM) in brain tumor associated epilepsy. We studied 47 patients with brain tumors and epilepsy. The entire group was administered AEDs. TPM was the first therapeutic choice in 14 patients, while in the remaining 33 patients previous AEDs were modified and TPM was introduced due to side effects or inefficacy of the first drug. Follow-up ranged from 3 to 48 months (mean 16.5 months). Considering the final follow-up of each patient who assumed TPM for at least 3 months, we observed 45 patients: 25 were seizure free (55.6%), 9 had a reduction of seizure frequency (SF) higher than 50% (20%) and 11 were stable (24.4%). TPM responder rate was 75.6%. Three patients (6.4%) discontinued TPM for severe side effects (1 after 4 months and 2 after 1 month) and 4 (8.5%) had mild and reversible side effects. In the group of patients who had been in therapy with other AEDs prior to entering the study (n = 33), 19 patients had side effects (57.6%). During follow-up, the haematological parameters were in the normative ranges. Tumor-related seizures are difficult to control with AEDs; the precise reasons for this difficulty are not yet clear. Using TPM, we obtained good seizure control with a low incidence of side effects.
脑肿瘤患者的癫痫通常对药物治疗难治，并且会使这些患者的治疗管理复杂化。我们进行了一项前瞻性观察研究。本研究的目的是调查托吡酯（TPM）治疗脑肿瘤相关性癫痫的疗效和耐受性。我们研究了47例患有脑肿瘤和癫痫的患者。整个组均给予抗癫痫药物（AEDs）。14例患者将TPM作为首选治疗药物，而其余33例患者由于第一种药物的副作用或无效而对先前的AEDs进行了调整并引入了TPM。随访时间为3至48个月（平均16.5个月）。考虑到每名服用TPM至少3个月的患者的最终随访情况，我们观察了45例患者：25例无癫痫发作（55.6%），9例癫痫发作频率（SF）降低超过50%（20%），11例病情稳定（24.4%）。TPM的有效率为75.6%。3例患者（6.4%）因严重副作用停用TPM（1例在4个月后，2例在1个月后），4例患者（8.5%）有轻度且可逆的副作用。在进入研究前曾使用其他AEDs治疗的患者组（n = 33）中，19例患者有副作用（57.6%）。随访期间，血液学参数在正常范围内。AEDs难以控制与肿瘤相关的癫痫；造成这种困难的确切原因尚不清楚。使用TPM，我们获得了良好的癫痫控制，且副作用发生率较低。
