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儿童癫痫治疗的新药:氨己烯酸(61例受试者的研究)

[New drugs in the treatment of childhood epilepsy: vigabatrin (study of 61 subjects)].

作者信息

Raucci U, Spalice A, Basile L A, Guardalà C, Nasta L, Terenzi S, Iannetti P

机构信息

Servizio Speciale di Neuropediatria, Università La Sapienza di Roma, Italia.

出版信息

Pediatr Med Chir. 1994 Nov-Dec;16(6):575-8.

PMID:7708543
Abstract

This study was conducted to determine the efficacy of vigabatrin in children with epilepsy. Sixty-one children with various types of severe epilepsy were studied. In 12 children vigabatrin was introduced as monotherapy, while in 49 it was added to other antiepileptic drugs. Following the introduction of vigabatrin, 17 patients became seizure free, and 19 responded with a greater than 50% reduction in seizure frequency. The following types of epilepsy responded favorably to treatment (in order of decreasing efficacy): West syndrome, especially if secondary to Tuberous Sclerosis; cryptogenic and symptomatic partial epilepsy; Lennox-Gastaut syndrome, and other symptomatic generalized epilepsy. Optimal responses were found with vigabatrin doses of 30 to 50 mg/kg/day. Forty-one responders continued on vigabatrin, with generally good efficacy. Vigabatrin tolerability was good; in only 6 children was treatment discontinued because of side-effects such as somnolence, irritability, weight gain, and cutaneous rash. This study shows that vigabatrin is effective in the treatment of refractory epilepsy, especially in West syndrome secondary to Tuberous Sclerosis, partial epilepsy, and Lennox-Gastaut syndrome. Further studies are needed to analyze the increased frequency of seizures and the appearance of new seizure types associated with vigabatrin treatment.

摘要

本研究旨在确定氨己烯酸治疗儿童癫痫的疗效。研究了61名患有各种类型严重癫痫的儿童。12名儿童将氨己烯酸作为单一疗法使用,49名儿童将其添加到其他抗癫痫药物中。使用氨己烯酸后,17名患者癫痫发作停止,19名患者癫痫发作频率降低超过50%。以下类型的癫痫对治疗反应良好(按疗效递减顺序):韦斯特综合征,尤其是继发于结节性硬化症的情况;隐源性和症状性部分性癫痫;伦诺克斯-加斯东综合征,以及其他症状性全身性癫痫。氨己烯酸剂量为30至50mg/kg/天时疗效最佳。41名有反应的患者继续使用氨己烯酸,总体疗效良好。氨己烯酸耐受性良好;仅6名儿童因嗜睡、易怒、体重增加和皮疹等副作用而停药。本研究表明,氨己烯酸对难治性癫痫有效,尤其是继发于结节性硬化症的韦斯特综合征、部分性癫痫和伦诺克斯-加斯东综合征。需要进一步研究分析与氨己烯酸治疗相关的癫痫发作频率增加和新癫痫发作类型的出现情况。

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