Cole Andrew J, Wiebe Samuel
Epilepsy Service, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. cole.andrew@.mgh.harvard.edu
Epilepsia. 2008 Dec;49 Suppl 9:29-34. doi: 10.1111/j.1528-1167.2008.01924.x.
There is no consensus on whether or when to stop anticonvulsant drug treatment in patients after apparently successful epilepsy surgery. Although there are compelling reasons to consider antiepileptic drug (AED) discontinuation, there are relatively few data, and no class 1 data, to guide patient and physician decision-making on this topic. This debate lays out a conceptual framework for considering the issue of AED discontinuation, and reviews and critiques the available data. The goal is to provide physicians with the best available data, a context in which to consider it, and a full understanding of its limitations. This article also highlights an area that is ripe for further prospective study.
对于癫痫手术明显成功后的患者,是否以及何时停止抗惊厥药物治疗尚无共识。尽管有令人信服的理由考虑停用抗癫痫药物(AED),但相对而言,用于指导患者和医生在该问题上决策的数据较少,且没有一级数据。这场辩论提出了一个用于考虑停用AED问题的概念框架,并对现有数据进行了回顾和批判。目标是为医生提供最佳可用数据、考虑这些数据的背景以及对其局限性的全面理解。本文还强调了一个有待进一步前瞻性研究的成熟领域。