托吡酯添加治疗小儿难治性癫痫的临床观察

Appraisal of the curative effect of Topiramate in the adjunctive treatmant of epilepsy in children

目的研究托吡酯治疗小儿癫痫的疗效与安全性。方法47例癫痫患儿,原来使用的抗癫药种类和剂量不变,将托吡酯作为辅助治疗药物,从0.50～1.00mg/(kg·d)开始,每周增加0.50～1.00mg/(kg·d),目标剂量4.00～9.00mg/(kg·d),根据癫发作情况调整托吡酯剂量。癫痫发作被控制后,原用抗癫药物逐渐减量直至停用。结果患儿治疗3个月后,总有效率,其中简单部分性发作为88.9%,复杂部分性发作为77.8%,症状性癫痫为83.3%。12例患儿在加量期出现轻、中度不良反应,不需特殊处理大多可自行消失。结论托吡酯治疗小儿癫痫疗效确切,安全性高,患儿耐受好。

[Objective ] To study the curative effect and safeness of Topiramate in the adjunctive treatment of epilepsy in children. [Methods] 47 patients with epilepsy were enrolled in the study. The kinds and dosages of antiepileptics formerly used by the patients remained unchanged in the p resent study. Topiramate was then used as an additive remedy, beginning with a dose of 0.50-1.00 mg/（kg·d） per os. The dose was increased by 0.50-1.00 mg/ kg·d every week, aiming at a final dose of 4.00-9.00 mg/（kg·d）. When, however, obvious curative effects appeared, the gradual increase in the dosage of the drug was stopped and the dosage on that very day was taken as the maintenance dose thereafter. The antiepileptics formerly used by the patients were given in gradually decreasing doses followed by discontinuation of the drugs after the epilepsy had been controlled. [Results] After 3 months treatment, the overall effective rate of the simple partial seizure （SIX3） was 88.9%, complex partial seizure （CPS） was 77.8%, and symptomatic epilepsy was 83.3%. Adverse reactions were encountered in 12 patients when the doses of Topiramate were steadily increased. These reactions usually disappeared spontaneously demanding no particular managements. [Conclusion] Topiramate was shown to exert defihite curative effects in the treatment of epilepsy in children.