Carmant L, Holmes G L, Sawyer S, Rifai N, Anderson J, Mikati M A
Department of Neurology, Children's Hospital, Boston, MA 02115.
J Pediatr. 1994 Sep;125(3):481-6. doi: 10.1016/s0022-3476(05)83302-5.
Thirty children (2 to 17 years of age) with refractory partial seizures received open-label felbamate as an add-on medication to their background antiepileptic drugs. The dose was increased up to a maximum of 45 mg/kg. Compared with baseline seizure activity, there was a 53% decrease in seizure frequency during felbamate therapy; 50% of the patients had more than a 50% decrease in seizure frequency. Patients older than 10 years of age were more likely to have a favorable response. Age correlated positively with felbamate concentrations and negatively with apparent felbamate clearance. Transient weight loss occurred in 57% of the patients; the weight loss was maximal after 12 weeks of initiation of felbamate, and subsided after the twentieth week of treatment. Anorexia and insomnia were reported in 20% and 16% of the patients, respectively. Adverse effects were generally tolerable; felbamate therapy was discontinued because of side effects in only one patient, because of a rash. We conclude that felbamate can be a useful and well-tolerated medication in the treatment of refractory partial epilepsy in children. However, increased apparent clearance of this drug in younger children should be considered in treatment of this age group.
30名患有难治性部分性癫痫发作的儿童（年龄在2至17岁之间）在其基础抗癫痫药物治疗的基础上，接受了开放标签的非氨酯附加治疗。剂量逐渐增加，最大剂量为45mg/kg。与基线癫痫发作活动相比，非氨酯治疗期间癫痫发作频率降低了53%；50%的患者癫痫发作频率降低超过50%。10岁以上的患者更有可能产生良好反应。年龄与非氨酯浓度呈正相关，与非氨酯表观清除率呈负相关。57%的患者出现短暂体重减轻；体重减轻在开始使用非氨酯12周后达到最大程度，并在治疗第20周后消退。分别有20%和16%的患者报告出现厌食和失眠。不良反应总体上可耐受；仅1例患者因皮疹等副作用而停用非氨酯治疗。我们得出结论，非氨酯在治疗儿童难治性部分性癫痫中可能是一种有用且耐受性良好的药物。然而，在治疗该年龄组患者时，应考虑到该药物在年幼儿童中表观清除率增加的情况。
