Reynolds E H, Shorvon S D, Galbraith A W, Chadwick D, Dellaportas C I, Vydelingum L
Epilepsia. 1981 Aug;22(4):475-88. doi: 10.1111/j.1528-1157.1981.tb06158.x.
Of 31 previously untreated patients with grand mal and/or partial seizures referred to a neurological clinic and treated with phenytoin monotherapy, assisted by serum level monitoring, 26 have been followed up for a mean of 42 months. Seizures were completely controlled in 80%. Failure of optimum phenytoin monotherapy occurred in 12%. The degree of seizure control was significantly related to phenytoin serum levels. The success of monotherapy was probably related to availability of serum level monitoring and to the study of a previously untreated population with a relatively short history of epilepsy. The main reasons for failure of monotherapy were poor compliance and the presence of additional neuropsychiatric handicaps, which commonly occur together. The place for polytherapy in the event of failure of monotherapy has still to be defined.
在31例之前未接受过治疗的全身性强直阵挛发作和/或部分性发作患者中，这些患者被转诊至一家神经科诊所并接受苯妥英单药治疗，同时辅助进行血药浓度监测，其中26例患者接受了平均42个月的随访。80%的患者癫痫发作得到完全控制。苯妥英单药治疗效果欠佳的情况占12%。癫痫发作的控制程度与苯妥英血药浓度显著相关。单药治疗的成功可能与血药浓度监测的可行性以及对癫痫病史相对较短的未治疗人群的研究有关。单药治疗失败的主要原因是依从性差以及存在额外的神经精神障碍，这两种情况通常同时出现。单药治疗失败时联合治疗的地位仍有待确定。
