Chamberlain M C
University of California San Diego, La Jolla, 92093-0812, USA.
J Child Neurol. 1996 Jan;11(1):31-4. doi: 10.1177/088307389601100107.
Infantile spasms and the Lennox-Gastaut syndrome are considered to be age-specific pediatric epileptic syndromes and together constitute a significant percentage of medically resistant seizures in childhood. Twenty children, ages 4 to 28 months (median, 12 months), with medically refractory infantile spasms or the Lennox-Gastaut syndrome, were treated with the investigational benzodiazepine nitrazepam in an open-label study. Daily dosage of nitrazepam ranged from 0.5 to 3.5 mg/kg, with a median dosage of 1.5 mg/kg, divided into two doses per day. Side effects included pooling of oral secretions (12 children) and sedation (six children); however, no serious side effects were seen. Responses to nitrazepam were as follows: five complete responses (cessation of all seizures), seven partial responses (greater than 50% reduction of seizures), and eight with no response. Median duration of response was 9 months (range, 4 to 16 months) in children with infantile spasms and 14 months (range, 8 to 26 months) in children with the Lennox-Gastaut syndrome. Nitrazepam is an effective anticonvulsant in this small cohort of children with medically refractory infantile spasms and the Lennox-Gastaut syndrome, resulting in a 25% response rate and only modest side effects.
婴儿痉挛症和Lennox-Gastaut综合征被认为是特定年龄段的小儿癫痫综合征，在儿童期药物难治性癫痫发作中占相当大的比例。在一项开放标签研究中，对20名年龄在4至28个月（中位数为12个月）、患有药物难治性婴儿痉挛症或Lennox-Gastaut综合征的儿童使用了研究性苯二氮䓬类药物硝西泮进行治疗。硝西泮的每日剂量为0.5至3.5毫克/千克，中位数剂量为1.5毫克/千克，分两次服用。副作用包括口腔分泌物积聚（12名儿童）和镇静作用（6名儿童）；然而，未观察到严重副作用。对硝西泮的反应如下：5例完全缓解（所有癫痫发作停止），7例部分缓解（癫痫发作减少超过50%），8例无反应。婴儿痉挛症患儿的反应持续时间中位数为9个月（范围为4至16个月），Lennox-Gastaut综合征患儿为14个月（范围为8至26个月）。在这一小群患有药物难治性婴儿痉挛症和Lennox-Gastaut综合征的儿童中，硝西泮是一种有效的抗惊厥药物，缓解率为25%，且副作用较小。
