氯氮平治疗精神分裂症致癫痫样放电脑电图分析

A Study on EEG of Leading to Epileptiform Discharges with Clozapine in Treatment of Schizophrenia.

目的 探讨氯氮平治疗精神分裂症过程中EEG异常改变，预测药源性癫痫临床发作。方法 精神分裂症患者入院后单用氯氮平治疗，服用氯氮平剂量在100～150mg／d、175～300mg／d、325～600mg／d时分别行EEG检查。结果 共72例精神分裂症患者EEG发现癫痫样放电，其中服用氯氮平175～300mg／d时有5例（6．94％）发现癫痫样放电（未见癫痫临床发作），325～600mg／d时发现67例（93．06％）有癫痫样放电，其中34例（50．75％）出现癫痫临床发作（2例癫痫频发）。减量或停用氯氮平、同时加用抗癫痫药物后痫样放电消失、癫痫发作停止、慢波减少、EEG逐渐恢复。结论 EEG痈样放电与服用氯氮平剂量呈正相关。临床上可以通过EEG检查来预测药源性癫痫的发作。

Objective To study the electroencephalogram （EEG） changes with clozapine in treatment of schizophrenic patients so that we can predicte the clinical epilepsy seizures by EEG. Methods The schizophrenic patients were treated with clozapine. All the patients were checked by EEG when they were treated with clozapine at 100～150mg/d, 175～300mg/d, 325～600mg/d. Results Epileptiform discharges occurred in 72 cases of the schizophrenic patients. 5 of them （6. 940/00） whose EEG were found epileptiform discharges （no epilepsy seizure） when they were treated with clozapine at 175～300mg/ d. 67 schizophrenic patients out of 72 ones （93.06%） whose EEG occurred epileptiform discharges when they were treated with clozapine at 325～ 600rag/d, and 34 cases of them occurred epilepsy seizures. After reduce or stop clozapine treatment both the epilepsy seizures and the epileptiform discharges disappeared. Conclusion There were positive correlation between the epileptiform discharges and the dosage of clozapine. We can predicte the occurrence of epilepsy seizures by EEG during clozapine treatment.