左乙拉西坦治疗儿童癫痫的有效性和耐受性：回顾性研究。

Effectiveness and tolerability of zonisamide in children with epilepsy: a retrospective review.

机构信息

Department of Paediatric Neurology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.

出版信息

Seizure. 2010 Jan;19(1):31-5. doi: 10.1016/j.seizure.2009.10.008. Epub 2009 Nov 25.

DOI:10.1016/j.seizure.2009.10.008

PMID:19942456

Abstract

PURPOSE

To evaluate the effectiveness and tolerability of zonisamide in children with epilepsy.

METHOD

Retrospective case note review of young people (less than 19 years) with epilepsy from three UK tertiary centres who received treatment with zonisamide and were followed up for a minimum of 12 months.

RESULTS

Fifty-seven children were included, aged 1.5-18.5 (median, 12) years. Thirty-three (57.9%) patients had generalised epilepsy, 21 (36.8%) focal epilepsy, and three (5.3%) a mixed, generalised and focal, epilepsy. Fifty-six of the 57 patients had been refractory to at least three previous antiepileptic drugs. The maintenance dose of zonisamide was [range (median)] 0.7-14 (5)mg/kg/day. The median duration of treatment for all patients was 12 (range 0.25-35) months. After 2 months of treatment, 51 patients remained on zonisamide, 18 (35.3%) of whom demonstrated a > or =50% reduction in seizure frequency. At the end of the follow-up period, there was a loss of effect for some patients. Thirteen (25.5%) of the 51 patients continued to demonstrate a > or =50% reduction in seizure frequency whilst two who had become seizure-free started having seizures again. Six (11.8%) had <50% reduction, twenty-four (47%) had no change, and eight (15.7%) had increasing seizures. Twenty-five (43.9%) patients reported unwanted effects although this contributed to the withdrawal of zonisamide in only ten (17.6%) patients.

CONCLUSIONS

Zonisamide appeared to be a reasonably effective and generally well-tolerated antiepileptic drug in a heterogeneous group of 57 children with poorly controlled epilepsy and provides another treatment option for children with refractory seizures.

摘要

目的

评估左乙拉西坦在癫痫儿童中的有效性和耐受性。

方法

对来自英国三个三级中心的接受左乙拉西坦治疗并至少随访 12 个月的年轻患者（<19 岁）进行回顾性病历审查。

结果

共纳入 57 例儿童，年龄 1.5-18.5 岁（中位数 12 岁）。33 例（57.9%）患者为全面性癫痫，21 例（36.8%）为局灶性癫痫，3 例（5.3%）为混合性、全面性和局灶性癫痫。57 例患者中，56 例对至少三种先前的抗癫痫药物耐药。左乙拉西坦的维持剂量为[范围（中位数）]0.7-14（5）mg/kg/天。所有患者的中位治疗时间为 12（范围 0.25-35）个月。治疗 2 个月后，51 例患者仍继续服用左乙拉西坦，其中 18 例（35.3%）癫痫发作频率降低≥50%。在随访结束时，一些患者的疗效丧失。51 例患者中，有 13 例（25.5%）继续表现出癫痫发作频率降低≥50%，而 2 例无发作的患者再次出现癫痫发作。6 例（11.8%）患者癫痫发作频率降低<50%，24 例（47%）患者无变化，8 例（15.7%）患者癫痫发作频率增加。25 例（43.9%）患者报告出现不良反应，但这仅导致 10 例（17.6%）患者停用左乙拉西坦。