托吡酯加用传统抗癫痫药治疗难治性癫痫部分性发作16例

Study of the safety and efficacy of AEDs plus topiramate in treatment of refractory partial epilepsy

目的 :观察托吡酯加用传统抗癫痫药对难治性癫痫部分发作治疗的临床疗效和耐受性。方法 :对 16例难治性部分性发作患者加用托吡酯进行治疗 ,2 5mg/d为起始剂量 ,每周增加 2 5mg ,至 2 0 0mg/d维持治疗 ,观察加用治疗前后癫痫发作频率的改变和耐受性。结果 :观察 2 4周后 7例 (4 3 .8% )发作频率减少≥ 5 0 % ,其中 3例(18.8% )停止发作 ,2例 (12 .5 % )发作频率减少 2 6 %～ 49% ,5例发作频率减少≤ 2 5 % ,1例发作频率明显增加 ,1例观察 12周后失访。结论 :托吡酯作为具有多重作用机制的抗癫痫新药 ,加用治疗难治性癫痫部分性发作的总有效率为 5 6 .3% (9/ 16 ) ,无明显的必须停药的不良反应 。

Objective:To study the safety and efficacy of AEDs plus topiramate in treatment of refractory partial epilepsy.Methods:The open,self controlled clinical trial was conducted in 16 patients with refractory partial epilepsy.They were treated with topiramate in an initial dose of 25mg/d and then increased by 25mg every week untill a dose of 200mg/d was achieved and maintained at that dose.The seizure rate and tolerability were observed before and after add on therapy.Results:After 24 weeks of treatment,the seizure rate was decreased by ≥50% in 7 cases(43.8%;including 3 cases of no seizure),2 cases decrease in seizure rate of 26%～49% and by≤25% in 5 cases.In the contrary,the seizure rate was significantly increased in 1 case and failed to follow up in 1 case after 12 weeks of treatment.Conclusion:Data obtain shows that topiramate is a new antiepileptic agent with multiple mechanism of action,the total effective rate in the add on therapy is 56.3%(9/16)without severe side effect,with good tolerability in treatment of refratory partial epilepsy.