Miyamoto A, Takahashi S, Oki J, Itoh J, Cho K
Department of Pediatrics, Asahikawa Medical College.
No To Hattatsu. 1995 Jan;27(1):23-8.
We treated one hundred and seventy-eight epileptic children with carbamazepine (CBZ) for eight years. Among them, four children with symptomatic localization-related epilepsy, aged 11 months to 12 years, developed exacerbation of seizures. Their epilepsies were associated with hypoxic ischemic encephalopathy, head injury and ectopic gray matter. Despite the serum levels of CBZ (7.0 approximately 9.5 micrograms/ml) being within the therapeutic range, all of them had more frequent and severe partial seizures than before taking CBZ and one developed new atonic seizures. Diffuse irregular spike-wave complexes appeared on EEG in two children. Following discontinuation of CBZ in addition to replacement with phenytoin, their seizures became well-controlled and EEG findings improved except for residual focal spikes. Although CBZ is a widely used and effective antiepileptic drug for partial seizures, it should be kept in mind that CBZ may exacerbate seizures in children with symptomatic localization-related epilepsy.
我们用卡马西平（CBZ）治疗178例癫痫儿童长达8年。其中，4例症状性局灶性相关性癫痫儿童，年龄在11个月至12岁之间，癫痫发作加重。他们的癫痫与缺氧缺血性脑病、头部外伤和灰质异位有关。尽管CBZ的血清水平（7.0至9.5微克/毫升）在治疗范围内，但他们所有人的部分性癫痫发作都比服用CBZ前更频繁、更严重，且有1例出现了新的失张力发作。2例儿童脑电图出现弥漫性不规则棘慢复合波。除了用苯妥英钠替代外，停用CBZ后，他们的癫痫发作得到了很好的控制，脑电图结果除残留局灶性棘波外有所改善。尽管CBZ是一种广泛使用且对部分性癫痫有效的抗癫痫药物，但应记住，CBZ可能会使症状性局灶性相关性癫痫儿童的癫痫发作加重。
