Larson A W, Wasserstrom W R, Felsher B F, Chih J C
Neurology. 1978 Aug;28(8):824-8. doi: 10.1212/wnl.28.8.824.
A patient with uncontrolled posttraumatic epilepsy and acute intermittent prophyria was subjected to successive therapeutic trials with phenytoin, carbamazepine, and clonazepam, while eating an adequate diet. Both phenytoin and carbamazepine treatments caused significant increases in porphobilinogen excretion and appeared to induce acute porphyric attacks. In contrast, treatment with clonazepam under rigid dietary control for 10 days caused no increase in porphilbinogen excretion. During the subsequent 7 months of treatment with clonazepam, neither seizures nor porphyric attacks recurred. These findings suggest that clonazepam may be a safe and effective treatment for chronic or severe generalized seizure disorders in patients with acute intermittent porphyria.
一名患有创伤后癫痫未得到控制且患有急性间歇性卟啉病的患者，在保持充足饮食的情况下，先后接受了苯妥英钠、卡马西平和氯硝西泮的治疗试验。苯妥英钠和卡马西平治疗均导致卟胆原排泄显著增加，且似乎诱发了急性卟啉病发作。相比之下，在严格饮食控制下用氯硝西泮治疗10天，卟胆原排泄未增加。在随后用氯硝西泮治疗的7个月里，癫痫发作和卟啉病发作均未复发。这些发现表明，氯硝西泮可能是治疗急性间歇性卟啉病患者慢性或严重全身性癫痫障碍的一种安全有效的疗法。
