Hau Man To Harmony, Shek-Kwan Chang Richard, On-Kei Chan Angel, Lam Chan Phoebe Wing
Department of Medicine, Queen Mary Hospital, Hong Kong.
Division of Neurology, Queen Mary Hospital, Hong Kong.
Epilepsy Behav Case Rep. 2017 Jul 19;8:66-68. doi: 10.1016/j.ebcr.2017.07.002. eCollection 2017.
A 27-year-old man with a diagnosis of new onset refractory status epilepticus (NORSE) was treated with five anti-seizure drugs (ASDs) including clobazam, levetiracetam and topiramate. He received plasma exchange (PE) for presumed autoimmune etiology. Serum ASD levels were serially monitored in two sessions. Levels of clobazam, levetiracetam and topiramate were significant reduced by PE. Serum clobazam level dropped down to at least 85% and 75% of the baseline during and after the procedure respectively; levetiracetam dropped down to 83% and 83%; and topiramate dropped to 86% and 79%. The results may imply a theoretical risk of breakthrough seizure during PE due to low ASD levels.
一名被诊断为新发难治性癫痫持续状态（NORSE）的27岁男性接受了包括氯巴占、左乙拉西坦和托吡酯在内的五种抗癫痫药物（ASD）治疗。他因推测的自身免疫病因接受了血浆置换（PE）。在两个疗程中对血清ASD水平进行了连续监测。PE使氯巴占、左乙拉西坦和托吡酯的水平显著降低。血清氯巴占水平在治疗期间和治疗后分别降至基线的至少85%和75%；左乙拉西坦降至83%和83%；托吡酯降至86%和79%。结果可能意味着在PE期间由于ASD水平低而存在癫痫发作突破的理论风险。
