Lance J W, Anthony M
Med J Aust. 1977 Jun 18;1(25):911-5. doi: 10.5694/j.1326-5377.1977.tb131243.x.
Sodium valproate (Epilim) has been used in the management of 100 patients with previously uncontrolled epilepsy for periods up to 2 years. If all manifestations of epilepsy are considered together, 75% to 100% control of seizures was achieved in 43% of patients, 25% to 74% control in 26%, and no improvement occurred in 31% of patients. Control of 75% to 100% was achieved in 57% of patients with a spike and wave electroencephalogram (EEG) disturbance but only in 35% of those with focal abnormalities, excessive slow activity, or normal records. When the various manifestations of epilepsy were considered individually, the greatest improvement was found among the patients with the minor forms of generalized epilepsy (petit mal absences, myoclonus and atonic attacks) in whom 75% to 100% control was obtained in 67%, compared with 43% of those with major generalized seizures (grand mal) and 30% of those with temporal lobe attacks and other forms of focal epilepsy. Gastrointestinal disturbances and drowsiness were noted as side effects in the early stages of treatment, but the majority of patients tolerated the drug well and many commented on increased mental alertness while taking it. Two patients were over-stimulated and some noticed tremor or twitching as side effects. Some minor abnormalities in blood coagulation studies were noted, but these were transient and did not appear to be of clinical significance. Regular blood counts and biochemical studies have not shown any significant changes. Sodium valproate appears to be a safe and useful anticonvulsant with the advantage that it usually makes patients brighter rather than drowsier. Abnormalities of platelet function have been described in some overseas reports, so that any unexplained bruising or bleeding in a patient taking valproate is an indication for a platelet count and coagulation studies.
丙戊酸钠（德巴金）已用于治疗100例既往癫痫控制不佳的患者，治疗时间长达2年。如果综合考虑癫痫的所有表现，43%的患者癫痫发作得到75%至100%的控制，26%的患者发作得到25%至74%的控制，31%的患者无改善。脑电图（EEG）有棘波和慢波异常的患者中，57%的患者发作得到75%至100%的控制，但在有局灶性异常、过度慢波活动或脑电图正常的患者中，这一比例仅为35%。当单独考虑癫痫的各种表现时，在轻度全身性癫痫（失神小发作、肌阵挛和失张力发作）患者中改善最为明显，67%的此类患者发作得到75%至100%的控制，相比之下，全身性大发作患者中这一比例为43%，颞叶发作和其他局灶性癫痫患者中为30%。在治疗早期，注意到胃肠道不适和嗜睡是副作用，但大多数患者对该药物耐受性良好，许多患者表示服药期间精神警觉性提高。有两名患者出现过度兴奋，一些患者注意到震颤或抽搐是副作用。凝血研究中发现了一些轻微异常，但这些异常是短暂的，似乎没有临床意义。定期血常规和生化检查未显示任何显著变化。丙戊酸钠似乎是一种安全有效的抗惊厥药物，其优点是通常使患者更清醒而非嗜睡。一些海外报告中描述了血小板功能异常，因此服用丙戊酸钠的患者出现任何无法解释的瘀伤或出血，都需要进行血小板计数和凝血研究。
