帕金森病首发癫痫患者的合理用药分析

Rational Drug Use Analysis of Parkinson's Disease with the First Time Attack of Epilepsy

目的:引起临床医生对于帕金森病患者首发癫痫诊治的重视,促进临床药物的合理使用,以减少不良反应的发生。方法:临床药师从其发病机制、治疗方法和药学监护等方面对1例帕金森病首发癫痫患者进行综合分析。结果:对于抗帕金森治疗过程中发生的癫痫样发作与左旋多巴(L-dopa)导致的帕金森病药源性异动症难以区分,治疗方案难以把握;抗癫痫药物中丙戊酸(VPA)对帕金森综合征具有潜在的诱发或加重作用且起病不易察觉,临床易忽视。结论:在L-dopa治疗过程中应尽量避免帕金森药源性异动症的发生,合并首次癫痫发作的患者要加以区分,合理选用抗癫痫药物治疗。

Objective： To bring to doctors＇ attention to the first time attack of epilepsy in the patients with Parkinson＇ s disease, enhance the rational drug use and reduce the occurrence of adverse reactions in clinics. Methods： A Parkinson patient with the first time attack of epilepsy was synthetically analyzed on the mechanism of disease, therapy regimen and pharmaceutical care. Results： It was difficult to distinguish the symptom of epilepsy during the treatment of Parkinson＇ s disease from that of L-dopa induced dyskinesia, therefore, the suitable treatment was difficult to perform. Moreover, antiepileptic drug valproic acid could aggravate Parkinson syn- drome imperceptibly, which was easy to be ignored in clinics. Conclusion： L-dopa induced dyskinesia should try to avoid during the treatment of Parkinson, and should distinguish from the first time attack of epilepsy in order to choose proper antiepileptic drugs.