Comprehensive Epilepsy Center, Division of Neurology, MLC# 2015, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
CNS Drugs. 2013 Apr;27(4):273-86. doi: 10.1007/s40263-013-0048-z.
Partial-onset seizures contribute the bulk of seizure burden in childhood epilepsy. The therapeutic decision making involves consideration of factors specific to drug, patient and socioeconomic situation.
This paper systematically reviews the available efficacy/effectiveness evidence for various anti-epileptic drugs (AED) as monotherapy and adjunctive therapy for partial-onset seizures in children.
Relevant randomized clinical trials (RCTs) were identified by a structured PubMed search, supplemented by an additional hand search of reference lists and authors' files.
Eligible studies were reviewed and data extracted into tables. Included RCTs were classified based on accepted published criteria.
Only efficacy and effectiveness outcome measures were evaluated since there is little scientifically rigorous comprehensive AED adverse effects data.
Oxcarbazepine is the only AED with Class I evidence for efficacy/effectiveness as initial monotherapy for partial-onset seizures in children. Carbamazepine, clobazam, lamotrigine, phenobarbital, phenytoin, topiramate, valproate, vigabatrin and zonisamide have, at best, Class III efficacy/effectiveness evidence for monotherapy of partial-onset seizures in children. For adjunctive therapy, gabapentin, lamotrigine, levetiracetam, oxcarbazepine and topiramate have Class I efficacy/effectiveness evidence for treatment of pediatric partial-onset seizures.
This efficacy/effectiveness analysis must not be used in isolation when selecting therapy. AED selection for a specific child needs to integrate a drug's efficacy/effectiveness data with its safety and tolerability profile, pharmacokinetic properties, available formulations, and patient specific characteristics. It is critical that physicians and patients incorporate all these relevant variables when choosing AED therapy.
部分发作性癫痫在儿童癫痫中占大部分癫痫发作负担。治疗决策需要考虑药物、患者和社会经济状况的特定因素。
本文系统回顾了各种抗癫痫药物（AED）作为单药和辅助治疗儿童部分发作性癫痫的现有疗效/有效性证据。
通过结构化的 PubMed 搜索确定了相关的随机对照试验（RCT），并通过额外的参考文献和作者文件的手工搜索进行补充。
对符合条件的研究进行了审查，并将数据提取到表格中。纳入的 RCT 根据已接受的发表标准进行分类。
仅评估了疗效和有效性的结果测量，因为关于 AED 不良反应的科学严格的综合数据很少。
奥卡西平是唯一一种具有 I 级证据的 AED，可作为儿童部分发作性癫痫的初始单药治疗。卡马西平、氯巴占、拉莫三嗪、苯巴比妥、苯妥英钠、托吡酯、丙戊酸钠、氨己烯酸和左乙拉西坦在儿童部分发作性癫痫的单药治疗中具有最佳的 III 级疗效/有效性证据。对于辅助治疗，加巴喷丁、拉莫三嗪、左乙拉西坦、奥卡西平和托吡酯具有 I 级疗效/有效性证据，可治疗儿科部分发作性癫痫。
在选择治疗方法时，不能单独使用这种疗效/有效性分析。为特定儿童选择 AED 需要将药物的疗效/有效性数据与其安全性和耐受性特征、药代动力学特性、可用制剂以及患者的具体特征相结合。当选择 AED 治疗时，医生和患者将所有这些相关变量纳入考虑至关重要。
