Department for Psychophysiology and Organic Mental Disorders, University Psychiatric Clinic Vrapce, Zagreb, Croatia.
Epilepsy Behav. 2013 Aug;28(2):201-2. doi: 10.1016/j.yebeh.2013.05.015. Epub 2013 Jun 12.
The optimum drug treatment for ultrarefractory epilepsy after failure of seven prior antiepileptic drugs (AEDs) remains uncertain. Prompted by reports that adjunctive amantadine or l-dopa has been useful for children with refractory absence seizures and Lennox-Gastaut syndrome, we studied the utility of dopaminergic agents for adults with ultrarefractory epilepsy.
We assessed seizure control following adjunctive treatment for up to 12 months with the dopaminergic agent Madopar© in three adult patients with ultrarefractory epilepsy following brain injury or with Lennox-Gastaut syndrome, who had not achieved sustained seizure remission during past treatment with at least seven lifetime AEDs.
The adjunctive use of Madopar was associated with a reduction or remission of tonic-clonic seizures in two patients. However, Madopar seemed to have aggravated absence seizures in the patient with Lennox-Gastaut syndrome.
Although our preliminary observations do not and cannot establish the efficacy or safety of adjunctive Madopar, it may be an option for treatment of ultrarefractory focal seizures in adults if confirmed by randomized controlled trials.
在七种抗癫痫药物（AEDs）治疗失败后，超难治性癫痫的最佳药物治疗仍不确定。鉴于有报道称，辅助金刚烷胺或左旋多巴对难治性失神发作和 Lennox-Gastaut 综合征的儿童有效，我们研究了多巴胺能药物对超难治性癫痫成人的作用。
我们评估了 3 名脑损伤后或 Lennox-Gastaut 综合征的超难治性癫痫成年患者在辅助治疗期间（最多 12 个月）使用多巴胺能药物 Madopar©的疗效，这些患者在过去至少 7 种终生 AED 治疗期间未能持续缓解癫痫发作。
辅助使用 Madopar 使 2 名患者的强直阵挛性发作减少或缓解。然而，Madopar 似乎加重了 Lennox-Gastaut 综合征患者的失神发作。
尽管我们的初步观察结果不能也不会确定辅助 Madopar 的疗效和安全性，但如果通过随机对照试验得到证实，它可能是治疗成人超难治性局灶性癫痫发作的一种选择。
