Barcs G, Halász P
National Institute of Psychiatry and Neurology, Budapest, Hungary.
Acta Neurol Scand. 1996 Feb-Mar;93(2-3):88-93. doi: 10.1111/j.1600-0404.1996.tb00180.x.
The main objective of this retrospective study was the further exploration of the loss of efficiency of the clobazam therapy (CLOB tolerance) in resistant temporal lobe epilepsy (TLE).
For up to 42 months we closely followed the state of 55 TLE patients placed on CLOB as an add-on therapy. Also, we sought for a connection between CLOB tolerance and clinical characteristics.
By the end of the 1st month 71% of the patients were seizure-free; 20% improved; 3% relapsed totally and 6% did not respond at all. After 24 months 15% were seizure-free, 11% maintained the original improved state, 36% relapsed totally and 32% partially--which remained unchanged thereafter. Long-term efficiency was in inverse proportion to the pretreatment interictal spike activity. No significant cross-tolerance was noted between CLOB and clonazepam.
Although the problem of CLOB tolerance is hardly overestimated, the use of CLOB in the treatment of TLE deserves consideration--despite the possibilities new drugs offer.
这项回顾性研究的主要目的是进一步探索氯巴占疗法（氯巴占耐受性）在耐药性颞叶癫痫（TLE）中疗效丧失的情况。
在长达42个月的时间里，我们密切跟踪了55例接受氯巴占作为附加疗法的TLE患者的病情。此外，我们还探寻了氯巴占耐受性与临床特征之间的联系。
在第1个月末，71%的患者无癫痫发作；20%的患者病情改善；3%的患者完全复发，6%的患者完全无反应。24个月后，15%的患者无癫痫发作，11%的患者维持最初的改善状态，36%的患者完全复发，32%的患者部分复发，此后病情保持不变。长期疗效与治疗前发作间期棘波活动呈反比。未发现氯巴占与氯硝西泮之间存在显著的交叉耐受性。
尽管氯巴占耐受性问题不容小觑，但尽管有新药可供选择，氯巴占在TLE治疗中的应用仍值得考虑。
