Department of Neurology, Sheba Medical Center, Tel-Hashomer, Israel.
Acta Neurol Scand. 2011 Jul;124(1):22-7. doi: 10.1111/j.1600-0404.2010.01472.x. Epub 2011 Jan 6.
To determine the response rate of patients with juvenile myoclonic epilepsy (JME) to lamotrigine (LTG) and identify predictive factors for treatment response.
Medical records of 62 patients with JME were reviewed for demographic, clinical, and EEG parameters. We determined clinical response to LTG and compared LTG responders with non-responders.
There were 35 LTG responders (56%) and 27 non-responders (44%). JME patients without generalized tonic clonic seizures (GTCS) responded better to LTG (P = 0.04). Valproic acid (VPA) failure because of adverse events rather than lack of efficacy (P = 0.069) and delay in diagnosis (P = 0.07) showed a tendency toward good response to LTG.
LTG should be considered a drug of first choice for JME patients without GTCS. LTG as second-line treatment after VPA failure seems more appropriate for those patients whose reason for VPA failure is poor tolerability rather than lack of efficacy.
确定青少年肌阵挛癫痫（JME）患者对拉莫三嗪（LTG）的反应率，并确定治疗反应的预测因素。
回顾了 62 例 JME 患者的病历，以了解人口统计学、临床和脑电图参数。我们确定了 LTG 的临床反应，并比较了 LTG 应答者与非应答者。
有 35 例 LTG 应答者（56%）和 27 例非应答者（44%）。无全身性强直阵挛发作（GTCS）的 JME 患者对 LTG 的反应更好（P=0.04）。因不良反应而非缺乏疗效（P=0.069）和延迟诊断（P=0.07）而导致丙戊酸（VPA）失败的患者对 LTG 有良好反应的趋势。
对于无 GTCS 的 JME 患者，LTG 应被视为首选药物。对于那些因耐受性差而不是疗效不佳而导致 VPA 失败的患者，LTG 作为 VPA 失败后的二线治疗似乎更为合适。
