Tolou-Ghamari Zahra, Zare Mohammad, Habibabadi Jafar Mehvari, Najafi Mohammad-Reza
Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2013 May;4(Suppl 2):S330-7.
The challenge of antiepileptic drugs (AEDs) management is to attain the best compromise between the desire to maximize seizure control and the need to keep side-effects within tolerable limits for the individual patient. To reduce devastation in Iranian epileptic patients, the aim of this study was to explore the overall outcome following AEDs prescription.
A cross-sectional study of 36 patients located at the epilepsy ward, conducted to Isfahan Neurosciences Research Centre was carried out during the year 2011. Female (n = 17) and male subjects (n = 19) with a mean age of 27 years (range; 7-74 years) were studied. Variables including, sex, age, age of seizure onset, type, and number of AEDs, biochemical and hematological data were recorded in d-Base and statistical analyses were performed using SPSS (version 18) for windows.
The main drug to control seizure attack was carbamazepine and valproic-acid. The following tests were the most frequently influenced; alkaline phosphatase (AP), lymphocyte (Lymph), white blood cell (WBC) counts and hemoglobin (Hgb). There was a significant increase in (AP) (mean; 534.6 u/l(↑); [P = 0.02] in three patients and (Lymph) (55%(↑); [43-84] %(↑); [P = 0.04] in seven patients. WBC was lower than 4400 mm(3↓) (P = 0.02) in six patients. Hgb was significantly lower in 70.6% of women (11.8(↓); [10-14.2] g/dl(↓); [P = 0.04] and 68.4% of men population (12.3(↓); [9.7-13.8] g/dl(↓); [P = 0.01]. Mean age of epilepsy onset was 15.6 years (range: Birth-74 years). Analysis of drug prescriptions showed that the incidence of monotherapy and polypharmacy (2 up to six AEDs simultaneously) was 19.4% plus 80.6% respectively.
In Iranian epileptic population, effectiveness of treatment should be attributed by the close supervising of AEDs in relation to clinical circumstance, laboratory data, and therapeutic drug monitoring. Any significant change in patients' biochemical and hematological data may require close verifying for the rapid detection of severe anemia, leukopenia, lymphocytosis, osteomalacia, or liver failure.
抗癫痫药物（AEDs）管理面临的挑战在于，要在最大程度控制癫痫发作的愿望与将个体患者的副作用控制在可耐受范围内的需求之间达成最佳平衡。为减少对伊朗癫痫患者的损害，本研究旨在探讨AEDs处方后的总体结果。
2011年，在伊斯法罕神经科学研究中心对癫痫病房的36例患者进行了横断面研究。研究对象为女性（n = 17）和男性（n = 19），平均年龄27岁（范围：7 - 74岁）。将性别、年龄、癫痫发作起始年龄、AEDs的类型和数量、生化及血液学数据等变量记录在数据库中，并使用Windows版SPSS（18版）进行统计分析。
控制癫痫发作的主要药物是卡马西平和丙戊酸。受影响最频繁的检查项目如下：碱性磷酸酶（AP）、淋巴细胞（Lymph）、白细胞（WBC）计数和血红蛋白（Hgb）。3例患者的（AP）显著升高（平均值；534.6 u/l（升高）；[P = 0.02]），7例患者的（Lymph）升高（55%（升高）；[43 - 84]%（升高）；[P = 0.04]）。6例患者的WBC低于4400 mm³（降低）（P = 0.02）。70.6%的女性（11.8（降低）；[10 - 14.2] g/dl（降低）；[P = 0.04]）和68.4%的男性（12.3（降低）；[9.7 - 13.8] g/dl（降低）；[P = 0.01]）的Hgb显著降低。癫痫发作的平均起始年龄为15.6岁（范围：出生 - 74岁）。药物处方分析显示，单药治疗和多药治疗（同时使用2至6种AEDs）的发生率分别为19.4%和80.6%。
在伊朗癫痫患者群体中，治疗效果应通过结合临床情况、实验室数据和治疗药物监测对AEDs进行密切监督来体现。患者生化和血液学数据的任何显著变化都可能需要密切核查，以便快速检测出严重贫血、白细胞减少、淋巴细胞增多、骨软化或肝功能衰竭。
