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[开浦兰在脑肿瘤患者放疗期间及手术治疗后癫痫发作中的应用]

[Use of keppra during the radiotherapy in patients with brain tumors and epileptic seizures after surgical treatment].

作者信息

Shershever A S, Bentsion D L, Lavrova S A, Sorokova E V

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2008;108(10):31-6.

Abstract

Efficacy of keppra was studied in 52 patients, aged 10-55 years, after the surgical treatment of gliomas of the brain hemispheres. The medication was used (in combination with other anticonvulsant drugs and hormones) during the radiotherapy. In 30 (57,8%) of cases epileptic seizures were before the surgery. In 22 (42,2%) of patients they developed during the radiotherapy. Keppra was used in the regiment of "urgent aid" in relation to the appearance of seizures and increase of their frequency during the radiotherapy. Doses of keppra varied from 500 to 2500 mg (30-50 mg/kg/day) in a single dose. Then patients received the drug 2 times daily under the control of clinical and EEG presentations. A clinical effect, including the decrease of seizures frequency by 48,3% (p<0,001), positive changes of quality of seizures (more simple structure, reduced time of seizures), was observed for the first 24 h and in future the state of patients was stable. All patients have completed the course of radiotherapy. The choice of dose was depended on age, body mass and dynamics of clinical and EEG data.

摘要

在52例年龄为10 - 55岁的大脑半球胶质瘤手术治疗后的患者中研究了左乙拉西坦的疗效。在放疗期间使用该药物(与其他抗惊厥药物和激素联合使用)。30例(57.8%)患者在手术前就有癫痫发作。22例(42.2%)患者在放疗期间出现癫痫发作。针对放疗期间癫痫发作的出现及其频率增加,左乙拉西坦按照“急救”方案使用。左乙拉西坦单次剂量为500至2500毫克(30 - 50毫克/千克/天)。然后患者在临床和脑电图监测下每日服用该药物2次。在最初24小时观察到临床效果,包括癫痫发作频率降低48.3%(p<0.001)以及癫痫发作性质的积极变化(结构更简单、发作时间缩短),并且在后续患者状态保持稳定。所有患者均完成了放疗疗程。剂量的选择取决于年龄、体重以及临床和脑电图数据的变化情况。

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