Department of Neurology, Mainz Comprehensive Epilepsy and Sleep Medicine Center, Johannes Gutenberg-University, Mainz, Germany.
Department of Neurology, Philipps-University Marburg, Marburg, Germany.
Epileptic Disord. 2023 Apr;25(2):142-149. doi: 10.1002/epd2.20004. Epub 2023 May 8.
Due to the high mortality of patients with refractory status epilepticus (SE), new antiseizure medications (ASMs) are needed to improve long-term outcomes. In this study, we evaluated the efficacy and safety of eslicarbazepine acetate (ESL), a new sodium channel blocker, based on the data from a large epilepsy register.
Data on the efficacy and safety of ESL for the treatment of refractory SE were gathered from the Mainz Epilepsy Registry (MAINZ-EPIREG). Logistic regression was applied to identify predictors of status interruption.
In total, 64 patients with remote symptomatic refractory SE were treated with ESL. No cases of idiopathic generalized epilepsy were included. The average age was 61.4 ± 11.0 years. The median number of administered ASMs before the start of ESL was three. On average, 2 days had elapsed since the onset of SE before the administration of ESL. The initial dose of 800 mg/day was increased up to a maximum daily dose of 1600 mg in case of nonresponse. In 29 of 64 patients (45.3%), the SE could be interrupted within 48 h of ESL therapy. In patients with poststroke epilepsy, the control of SE was achieved in 62% of patients (15/23). The earlier initiation of ESL therapy was an independent predictor of control of SE. Hyponatraemia occurred in five patients (7.8%). Other side effects were not observed.
Based on these data, ESL may be used as an adjunct therapy for the treatment of refractory SE. The best response was found in patients with poststroke epilepsy. In addition, early initiation of ESL therapy appears to result in better control of SE. Besides a few cases of hyponatraemia, no other adverse events were detected.
由于难治性癫痫持续状态（SE）患者的死亡率较高，需要新的抗癫痫药物（ASM）来改善长期预后。在这项研究中，我们根据大型癫痫登记处的数据评估了新型钠离子通道阻滞剂依佐加滨（ESL）的疗效和安全性。
从美因茨癫痫登记处（MAINZ-EPIREG）收集了 ESL 治疗难治性 SE 的疗效和安全性数据。应用逻辑回归来确定状态中断的预测因素。
共有 64 例症状性远隔难治性 SE 患者接受了 ESL 治疗。不包括特发性全面性癫痫发作病例。平均年龄为 61.4±11.0 岁。开始使用 ESL 之前，中位数的 ASM 数量为 3 种。平均在 SE 发作后 2 天开始使用 ESL。起始剂量为 800mg/天，在无反应的情况下增至最大日剂量 1600mg。在 64 例患者中的 29 例（45.3%），在 ESL 治疗的 48 小时内 SE 可以得到控制。在脑卒中后癫痫患者中，62%（15/23）的患者控制了 SE。更早开始 ESL 治疗是控制 SE 的独立预测因素。5 例（7.8%）患者发生低钠血症。未观察到其他副作用。
基于这些数据，ESL 可用作治疗难治性 SE 的辅助治疗方法。在脑卒中后癫痫患者中效果最佳。此外，早期开始 ESL 治疗似乎可以更好地控制 SE。除了少数低钠血症病例外，未检测到其他不良事件。
