Hermanns G, Noachtar S, Tuxhorn I, Holthausen H, Ebner A, Wolf P
Bethel Epilepsy Centre, Bielefeld, Germany.
Epilepsia. 1996 Jul;37(7):675-9. doi: 10.1111/j.1528-1157.1996.tb00632.x.
To assess medical intractability in patients considered for restrictive epilepsy surgery.
Seventy-four patients received single drug treatment with carbamazepine (CBZ), phenytoin (PHT), and either phenobarbital (PB) or primidone (PRM). Medical intractability was established if seizure control was not obtained despite maximum tolerable doses of the drug. In all, 120 single drug treatments were administered with the drugs that has not been administered at maximal doses in monotherapy before the study.
Complete seizure control was not achieved in any patient. However, 7 patients (9.5%) had significant seizure reduction of at least 80%. In 4 patients, only the third antiepileptic drug (AED) proved effective.
The poor result of AED monotherapy in our patients may be attributed to the patients' long-standing chronic epilepsies and high seizure frequencies. Our findings suggest that despite the failure of one or two major AEDs in controlling seizures completely, further single drug treatment may still improve the quality of life in some patients who are candidates for epilepsy surgery.
评估考虑接受限制性癫痫手术患者的药物难治性。
74例患者接受卡马西平（CBZ）、苯妥英（PHT）以及苯巴比妥（PB）或扑米酮（PRM）的单药治疗。如果尽管使用了最大耐受剂量的药物仍未实现癫痫控制，则确定为难治性。总共进行了120次单药治疗，使用的药物是在研究前未以最大剂量用于单药治疗的药物。
没有患者实现完全癫痫控制。然而，7例患者（9.5%）癫痫发作显著减少至少80%。在4例患者中，仅第三种抗癫痫药物（AED）被证明有效。
我们患者中AED单药治疗效果不佳可能归因于患者长期的慢性癫痫和高发作频率。我们的研究结果表明，尽管一两种主要AED在完全控制癫痫发作方面失败，但进一步的单药治疗仍可能改善一些适合癫痫手术患者的生活质量。
