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静脉注射左乙拉西坦治疗遗传性全面性癫痫持续状态发作:病例报告及文献复习。

Intravenous lacosamide for treatment of absence status epilepticus in genetic generalized epilepsy: A case report and review of literature.

机构信息

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University, Frankfurt am Main, Germany.

出版信息

Acta Neurol Scand. 2018 Sep;138(3):259-262. doi: 10.1111/ane.12935. Epub 2018 Apr 6.

Abstract

BACKGROUND

Nearly 10 years after its introduction into the market, the significance of lacosamide in genetic generalized epilepsies is still unclear. Its new mode of action may qualify lacosamide as a therapeutic agent in this entity, but only a limited number of cases have been published so far.

AIM

To describe the efficacy of lacosamide as treatment in a patient with the absence status epilepticus.

METHOD

We report on a 28-year-old woman with genetic generalized epilepsy who suffered recurrent absence status epilepticus during video-EEG-monitoring. After treatment failure of first- and second-line medication, lacosamide was administered. The outcome in this patient was evaluated, and a systematic literature review was performed for the use of lacosamide in the absence status epilepticus.

RESULTS

After application of 400 mg lacosamide intravenously, the absence status epilepticus terminated within 30 minutes. No further seizures or epileptiform discharges reoccurred until the end of video-EEG-Monitoring 3 days later.

CONCLUSIONS

The role of lacosamide as a therapeutic option in patients with the absence status epilepticus is unclear. Only two cases have been reported so far with conflicting results. Further randomized controlled studies are required to validate the relevance of lacosamide as treatment for status epilepticus in genetic generalized and the absence epilepsy.

摘要

背景

拉科酰胺进入市场近 10 年后,其在遗传性全面性癫痫中的意义仍不清楚。它的新作用模式可能使拉科酰胺有资格成为该病症的治疗药物,但迄今为止,只有有限数量的病例被发表。

目的

描述拉科酰胺作为治疗失神持续状态的疗效。

方法

我们报告了一名 28 岁女性患者,患有遗传性全面性癫痫,在视频脑电图监测期间反复发作失神持续状态。一线和二线药物治疗失败后,给予拉科酰胺治疗。评估了该患者的结局,并对拉科酰胺在失神持续状态中的应用进行了系统的文献复习。

结果

静脉注射 400mg 拉科酰胺后,失神持续状态在 30 分钟内终止。直到 3 天后视频脑电图监测结束,没有再出现癫痫发作或癫痫样放电。

结论

拉科酰胺作为失神持续状态患者的治疗选择的作用尚不清楚。迄今为止,只有两例报告,结果相互矛盾。需要进一步的随机对照研究来验证拉科酰胺作为遗传性全面性和失神性癫痫状态癫痫治疗的相关性。

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