对1例进行性肌阵挛癫痫患者的药物监测

Medication monitoring on a patient with progressive myoclonic epilepsy

1例20a女性患者因进行性肌阵挛癫痫入院治疗。第1天给予口服丙戊酸钠缓释片0.5g,每日2次,氯硝西泮片1mg,每日3次。第2天患者出现了一次强直发作。针对智能降低,对症给予静脉点滴奥拉西坦注射液4g,每日1次,用药8d;由于患者拒绝注射给药,改为口服奥拉西坦0.8g,每日2次。第6天,家属诉患者月经不调,给予口服结合雌激素片1.25mg,每日1次,共使用21d。服用结合雌激素片第11天后加用口服安宫黄体酮片10mg,每日1次,共使用10d,服药4d后,月经结束。第13天和第16天患者均出现非癫痫性心因发作,给予吸氧、静脉注射安定15mg对症处理,症状改善。第17天患者要求出院。

A 20-year-old female patient was hospitalized for progressive myoclonic epilepsy.On day 1,the patient was orally treated with sodium valproate sustained-release tablets 0.5 g twice daily,clonazepam tablets 1 mg three times a day.On day 2,the patient developed tonic seizures with intelligence obstacle.The patient was intravenously treated with oxiracetam 4 g once daily for 8 days.Eight days later,the patient was orally treated with oxiracetam 0.8 g twice daily for her refusing the intravenous administration.On day 6,the patient complained of irregular menstruation,and conjugated estrogen tablets 1.25 mg once daily was orally given for 21 days.Eleven days after the medication of conjugated estrogen tablets,medroxyprogesterone acetate tablets 10 mg once daily was added for 10 days.Four days later,her menstruation stopped.On day 13 and on day 16,the patient suffered from psychogenic non-epileptic seizures,oxygen inhalation therapy and diazepam 15 mg by intravenous injection were used,and the symptoms of the patient improved.On day 17,the patient discharged from hospital.