Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, 875, Haeun-daero, Haeundae-gu, Busan 612-896, Republic of Korea.
Seizure. 2018 Aug;60:123-126. doi: 10.1016/j.seizure.2018.06.013. Epub 2018 Jun 15.
Oxcarbazepine is known as an effective first-line monotherapy for pediatric focal epilepsy. Lamotrigine has also been reported to have similar efficacy to and better tolerability than carbamazepine. Therefore, the effectiveness of oxcarbazepine and lamotrigine monotherapies was compared in patients with pediatric focal epilepsy.
A total of 116 patients in pediatric patients with partial epilepsy received lamotrigine (n = 43) or oxcarbazepine (n = 73) monotherapy. The clinical characteristics, seizure outcomes, reasons for drug discontinuation, retention rate and adverse effects were evaluated for each drug.
Oxcarbazepine was more commonly used than lamotrigine (69/73 vs. 23/43) as initial monotherapy. Lamotrigine showed better efficacy than oxcarbazepine in terms of the seizure outcome more than 12 months (P<0.05). Oxcarbazepine and lamotrigine showed similar tolerability in terms of the retention rate, drug discontinuation and adverse effects. The rates of successful discontinuation were similar for patients receiving these drug as initial monotherapy (P > 0.05). The seizure outcome was much better for lamotrigine than for oxcarbazepine in patients with normal MRI findings and normal development (P = 0.001, P = 0.01). The retention rate was high in patients with MRI abnormalities or developmental delay in the lamotrigine group. The choice of lamotrigine was the only independent variable that predicted a seizure-free state, even after correcting for clinical variables (OR = 4.80, P = 0.013).
Lamotrigine was superior to oxcarbazepine monotherapy because of its greater effectiveness in treating pediatric focal epilepsy. Lamotrigine can be selected as a first-line monotherapy in patients with or without abnormal MRI findings or delayed development.
奥卡西平是一种有效的儿科局灶性癫痫的一线单药治疗药物。拉莫三嗪也被报道具有与卡马西平相似的疗效和更好的耐受性。因此，比较了奥卡西平和拉莫三嗪单药治疗儿科局灶性癫痫患者的疗效。
共有 116 名儿科局灶性癫痫患者接受拉莫三嗪（n=43）或奥卡西平（n=73）单药治疗。评估了每种药物的临床特征、癫痫发作结局、停药原因、保留率和不良反应。
奥卡西平作为初始单药治疗的应用比拉莫三嗪更为常见（69/73 比 23/43）。奥卡西平和拉莫三嗪在 12 个月以上的癫痫发作结局方面，拉莫三嗪显示出更好的疗效（P<0.05）。奥卡西平和拉莫三嗪在保留率、停药和不良反应方面具有相似的耐受性。作为初始单药治疗的患者停药成功率相似（P>0.05）。在 MRI 结果正常和发育正常的患者中，拉莫三嗪的癫痫发作结局明显优于奥卡西平（P=0.001，P=0.01）。在拉莫三嗪组中，MRI 异常或发育迟缓的患者保留率较高。拉莫三嗪的选择是预测无癫痫状态的唯一独立变量，即使在校正临床变量后（OR=4.80，P=0.013）。
拉莫三嗪优于奥卡西平单药治疗，因为其在治疗儿科局灶性癫痫方面更有效。拉莫三嗪可作为 MRI 结果正常或异常或发育迟缓的患者的一线单药治疗选择。
