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

摘要

Objective:To study the safety and efficacy of AEDs p lus topiramate in treatment of refractory partial epilepsy.Methods :The open,self-controlled clinical trial was conducted in 16 patients with refr actory 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 achiev ed and maintained at that dose.The seizure rate and tolerability were observed b efore and after add-on therapy.Results:After 24 weeks of treatmen t,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 faile d to follow up in 1 case after 12 weeks of treatment.Conclusion:Da ta obtain shows that topiramate is a new antiepileptic agent with multiple mecha nism of action,the total effective rate in the add-on therapy is 56.3%(9/16)wit hout severe side effect,with good tolerability in treatment of refratory 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，25mg/d为起始剂量，每周增加25mg,至200mg/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24周后7例(43.8% )发作频率减少≥50%，其中3例(18.8%)停止发作，2例(12.5%)发作频率减少26%～49%，5例 发作频率减少≤25%，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56.3%(9/16)，无明显的必须停药的不良反应，耐受性良好。