Kork Epilepsy Centre, Kehl-Kork, Germany.
Epileptic Disord. 2012 Dec;14(4):379-87. doi: 10.1684/epd.2012.0544.
In order to assess the efficacy of modern antiepileptic drug (AED) therapy, we collected data from 517 consecutive adult outpatients referred to our centre between March and August 2011. In total, 211 patients (40.8%) were treated with monotherapy, 208 patients (40.2%) with a combination of two AEDs, and for the remaining patients (n=98; 19%) more than two AEDs were combined. The most common AEDs were valproate, lamotrigine, carbamazepine, and levetiracetam. Of the recent AEDs, levetiracetam was the leading drug with regards to drug combinations. Freedom of seizures for more than one year was achieved in 291 patients (56.3%). Under monotherapy, 168 patients (32.5% of all patients; 79.6% of patients with monotherapy) became seizure-free. Seizure-freedom with two AEDs was achieved in 103 patients (19.9% of all patients; 49.5% of patients with two AEDs) and in 20 patients with three AEDs (3.9% of all patients; 25.3% of patients with three AEDs). We conclude from this cross-sectional survey in a large patient group that combinations may still lead to treatment success in a considerable proportion of patients.
为了评估现代抗癫痫药物(AED)治疗的疗效,我们收集了 2011 年 3 月至 8 月期间 517 例连续成年门诊患者的数据。共有 211 例患者(40.8%)接受单药治疗,208 例患者(40.2%)接受两种 AED 联合治疗,其余患者(n=98;19%)接受两种以上 AED 联合治疗。最常见的 AED 是丙戊酸钠、拉莫三嗪、卡马西平和左乙拉西坦。在新型 AED 中,左乙拉西坦在药物联合应用方面处于领先地位。291 例患者(56.3%)癫痫发作持续一年以上得到控制。单药治疗中,168 例患者(所有患者的 32.5%;所有单药治疗患者的 79.6%)癫痫发作得到控制。两种 AED 联合治疗中,103 例患者(所有患者的 19.9%;所有两种 AED 治疗患者的 49.5%)和三种 AED 联合治疗中 20 例患者(所有患者的 3.9%;所有三种 AED 治疗患者的 25.3%)癫痫发作得到控制。我们从这项大型患者群体的横断面研究中得出结论,联合治疗仍可能使相当一部分患者获得治疗成功。