托吡酯快速加量法治疗小儿癫痫临床观察

The Clinical Study on Treatment of Epilepsy with Rapid Administration of Topamax

目的 观察托吡酯快速加量法治疗小儿癫痫时的疗效及不良反应。方法 对 30例符合1981年国际抗癫痫联盟的癫痫临床发作的分类与 1989年癫痫与癫痫综合征分类中的各型癫痫患儿在住院期间应用快速加量法给予托吡酯进行治疗。治疗剂量由小剂量开始 ,平均 1.0mg (kg·天 ) ,每2～ 3天增加 1.0mg kg ,平均 13天达目标剂量 [平均 4 .5mg (kg·天 ) ]至发作控制 ,同时观察疗效及副作用。结果 (1)托吡酯快速加量法治疗住院小儿癫痫 30例平均加药时间 13天达平均剂量 4 .5mg (kg·天 ) ,其总疗效为发作完全控制 14例 (4 6 .7% ) ,发作减少≥ 75 % 9例 (30 % ) ,发作减少≥ 5 0 % 5例 (6 .7% )。(2 )发生不良反应总例数 8例 (2 6 .7% )。表现为食欲降低 5例 (16 .7% ) ;低热为 3例 (10 % ) ;嗜睡、困倦 2例 (6 .7% ) ;多动、兴奋 2例 (6 .7% ) ;部分有交叉。结论 应用托吡酯治疗住院的癫痫儿童时可以快速加量 ,可以很快达到有效控制 ,安全。

Objective To investigate the curative effect and the side effect of Topamax in rapid administration on epilepsy children. Methods Thirty cases of inpatients that met standard diagnostic criteria in The Clinical Type of Epilepsy in 1981 and The Classification of Epilepsy and Epilepsy Syndrome in 1989, which made by The International Association of Anti-epilepsy, were administrated with Topamax rapidly. The administration that was added 1.0 mg/kgevery2-3days began from mini-dose [average 1.0 mg/(kg·d)]to attained remedial dose [average 4.5 mg/(kg·d)], which lasted 13 days in average. We evaluated the clinical curative effect and the side effect as well. Results (1) The rapid administration of Topamax in 30 cases of epilepsy of inpatients toke 13 days in average to attain remedial dose [average 4.5 mg/(kg·d)]. There were total 28 cases (93.3%) reached clinical curative effect: the attack were relived in 14 cases (46.7%), reduced over 75% in 9 cases (30%), and decreased over 50% in 5 cases (6.7%). (2) Eight cases (26.7%) had side effects which were intersected partially: poor appetite in 5 cases (16.7%), low fever in 3 cases (10%), sleepy in 2 cases (6.7%), and multi-moving and exiting in 2 cases (6.7%). Conclusions The treatment of Topamax in inpatients of epileptic children could administrate rapidly, that reaches clinical curative remedy quickly, has a few, soft side effects.