托吡酯成功治疗视神经脊髓炎患者的阵发性强直性痉挛
Successful treatment of paroxysmal tonic spasms with topiramate in a patient with neuromyelitis optica.
作者信息
Iida Shin, Nakamura Masataka, Wate Reika, Kaneko Satoshi, Kusaka Hirofumi
机构信息
Department of Neurology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 5731010, Japan.
Department of Neurology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 5731010, Japan.
出版信息
Mult Scler Relat Disord. 2015 Sep;4(5):457-459. doi: 10.1016/j.msard.2015.07.011. Epub 2015 Jul 23.
A 49-year-old woman with neuromyelitis optica (NMO) developed severe quadriplegia and frequent paroxysmal tonic spasms (PTS). Carbamazepine, although initially effective against PTS, caused drug eruption and she was unable to continue. PTS re-emerged after discontinuation of carbamazepine and hindered rehabilitation. Then topiramate was started, and PTS promptly disappeared. The patient became able to resume rehabilitation and her activity of daily life improved significantly. Carbamazepine and topiramate have a common pharmacological action to block voltage-gated sodium channels. The action may have contributed to inhibition of ephaptic transmission in the demyelinating lesions by NMO and eventually improved PTS.
一名49岁的视神经脊髓炎（NMO）女性患者出现了严重的四肢瘫痪和频繁的阵发性强直性痉挛（PTS）。卡马西平虽然最初对PTS有效，但引起了药疹，她无法继续使用。停用卡马西平后PTS复发，阻碍了康复进程。随后开始使用托吡酯，PTS迅速消失。患者能够恢复康复训练，日常生活活动能力显著改善。卡马西平和托吡酯具有共同的药理作用，即阻断电压门控钠通道。这种作用可能有助于抑制NMO脱髓鞘病变中的触突间传递，最终改善了PTS。
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