Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany.
Department of Acute Medicine, Schweizer Paraplegiker Zentrum, Notwill, Switzerland.
Seizure. 2021 May;88:7-11. doi: 10.1016/j.seizure.2021.03.019. Epub 2021 Mar 20.
The aim of the present study was to evaluate the safety and efficacy of the add-on treatment of stiripentol (STP) in adult patients with severely pharmacoresistant focal or multifocal epilepsy.
Data on adult patients treated with STP from March 2007 to July 2020 and with at least one clinical follow-up (FU) were retrospectively reviewed. Data on tolerability, efficacy and concomitant medication were evaluated at baseline, 6 months (5.5 ± 1.6 months (mean ± SD)) and 12 months (13.1 ± 3.9 months (mean ± SD)).
Data of 22 patients (54.5% male, mean age 34.4 ± 17.79 years (mean ± SD), including mean duration of epilepsy 17.6 ± 25.5 years (mean ± SD), median seizure frequency 30 ± 20 (median ± MAD) per month, and 63.6% being severely intellectually disabled, with 3 to 18 previous anti-seizure-drugs (ASD), were collected. After 6 months, 72.7% of the patients were still taking STP, and 31% of the patients were responders, including 13% who were seizure-free. The 12-month retention rate was 54.4 %, the response rate was 36.4% and 13.6% of patients were seizure-free at the 12-month FU. Reasons for discontinuation were increased seizure frequency, hyperammonaemia and encephalopathy.
STP seems to be a useful option in the treatment of patients with severely pharmacoresistant epilepsy. Prospective trials are necessary to examine the efficacy of STP in adult patients with pharmacoresistant focal epilepsy.
本研究旨在评估添加司替戊醇(STP)治疗成人严重药物难治性局灶性或多灶性癫痫的安全性和疗效。
回顾性分析 2007 年 3 月至 2020 年 7 月期间接受 STP 治疗且至少有一次临床随访(FU)的成年患者的数据。在基线、6 个月(5.5±1.6 个月(均值±SD))和 12 个月(13.1±3.9 个月(均值±SD))时评估耐受性、疗效和伴随药物治疗情况。
共收集了 22 名患者(54.5%为男性,平均年龄 34.4±17.79 岁(均值±SD),包括平均癫痫持续时间 17.6±25.5 年(均值±SD),中位数发作频率为 30±20(中位数±MAD)/月,63.6%存在严重智力障碍,有 3-18 种既往抗癫痫药物(ASD)。6 个月后,72.7%的患者仍在服用 STP,31%的患者为应答者,其中 13%的患者无发作。12 个月的保留率为 54.4%,应答率为 36.4%,12 个月 FU 时 13.6%的患者无发作。停药的原因是发作频率增加、高血氨血症和脑病。
STP 似乎是治疗严重药物难治性癫痫患者的一种有用选择。有必要进行前瞻性试验,以检查 STP 在药物难治性局灶性癫痫成年患者中的疗效。