鲁非酰胺加重失张力发作：一例报告。
Aggravation of atonic seizures by rufinamide: A case report.
作者信息
Bektaş Gonca, Çalışkan Mine, Aydın Ali, Pembegül Yıldız Edibe, Tatlı Burak, Aydınlı Nur, Özmen Meral
机构信息
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
出版信息
Brain Dev. 2016 Aug;38(7):654-7. doi: 10.1016/j.braindev.2016.02.005. Epub 2016 Feb 20.
BACKGROUND
Rufinamide is a novel antiepileptic drug used as adjunctive therapy in patients with Lennox-Gastaut syndrome and provides seizure control especially in tonic and atonic seizures. Rufinamide is expected to be effective in intractable epilepsy when atonic and tonic seizures exist. However, rufinamide induced seizure aggravation has been reported in a few patients, which was not associated with a specific type of seizure.
CASE
A 12-year-old boy with intractable epilepsy had tonic and atonic seizures despite treatment with valproic acid (3000mg/day), levetiracetam (3000mg/day) and clobazam (40mg/day). Rufinamide was administered as adjuvant therapy. After 2weeks on rufinamide, he experienced atonic seizure worsening, and the frequency of epileptic discharges increased. The deterioration in seizure frequency and epileptiform discharges resolved when rufinamide was discontinued.
CONCLUSION
Rufinamide may aggravate atonic seizures in patients with intractable epilepsy.
背景
卢非酰胺是一种新型抗癫痫药物，用于Lennox-Gastaut综合征患者的辅助治疗，尤其对强直发作和失张力发作有较好的癫痫控制效果。当存在失张力发作和强直发作时，卢非酰胺有望对难治性癫痫有效。然而，已有少数患者报告卢非酰胺可诱发癫痫发作加重，且与特定类型的发作无关。
病例
一名12岁难治性癫痫男孩，尽管接受了丙戊酸（3000毫克/天）、左乙拉西坦（3000毫克/天）和氯巴占（40毫克/天）治疗，仍有强直发作和失张力发作。给予卢非酰胺作为辅助治疗。服用卢非酰胺2周后，他的失张力发作恶化，癫痫放电频率增加。停用卢非酰胺后，癫痫发作频率和癫痫样放电的恶化情况得到缓解。
结论
卢非酰胺可能会加重难治性癫痫患者的失张力发作。
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