Aguglia U, Gambardella A, Le Piane E, De Sarro G B, Zappia M, Quattrone A
Institute of Neurological Sciences, University of Reggio Cal., School of Medicine, Catanzaro, Italy.
J Neurol. 1994 Oct;241(10):605-10. doi: 10.1007/BF00920624.
We prospectively compared the activating effect of chlorpromazine (CHLP, 50 mg, i.m.) versus sleep deprivation (SD) in 41 patients with a clinical diagnosis of partial epilepsy. Patients were selected on the basis of both seizure onset in adulthood and normal interictal awake EEG recordings. Twenty out of 41 patients (group A) were not yet treated because of either recent onset of epilepsy or misdiagnosis. The remaining 21 patients (group B) were treated with antiepileptic drugs (AED). A control group consisted of 18 healthy, volunteers (group C). All EEG recordings were scored by one observer according to a fixed protocol. In group A, SD and CHLP activated sleep EEG in 12 (60%) and 19 (95%) patients, respectively. This difference reached the limit of statistical significance (P = 0.05, McNemar test). In group B, SD and CHLP activated sleep EEG in 12 (57%) and 13 (62%) patients respectively. There was a significant (P < 0.02, exact Fisher test) intergroup difference (95% vs 62%) with respect to the activating effect of CHLP. No false-positive results were found in 18 control subjects. SD or CHLP activating procedures did not provoke any epileptic seizures in any of the groups. In conclusion, EEG activation by either SD or CHLP is highly specific in the diagnosis of adult-on-set partial epilepsy. Moreover, CHLP is more sensitive than SD in untreated patients, whereas the activating effect of CHLP may be partially attenuated by AED.
我们前瞻性地比较了氯丙嗪（CHLP，50毫克，肌肉注射）与睡眠剥夺（SD）对41例临床诊断为部分性癫痫患者的激活作用。患者入选标准为成年起病且发作间期清醒脑电图记录正常。41例患者中的20例（A组）因癫痫近期发作或误诊而尚未接受治疗。其余21例患者（B组）接受抗癫痫药物（AED）治疗。一个对照组由18名健康志愿者组成（C组）。所有脑电图记录均由一名观察者按照固定方案进行评分。在A组中，SD和CHLP分别使12例（60%）和19例（95%）患者的睡眠脑电图激活。这种差异达到了统计学意义的极限（P = 0.05，McNemar检验）。在B组中，SD和CHLP分别使12例（57%）和13例（62%）患者的睡眠脑电图激活。关于CHLP的激活作用，两组间存在显著差异（P < 0.02，确切Fisher检验）（95%对62%）。18名对照受试者未发现假阳性结果。SD或CHLP激活程序在任何一组中均未引发癫痫发作。总之，SD或CHLP引起的脑电图激活在成人起病的部分性癫痫诊断中具有高度特异性。此外，CHLP在未治疗患者中比SD更敏感，而CHLP的激活作用可能会被AED部分减弱。
