EXACERBATION OF SEIZURES IN CHILDREN BY CARBAMAZEPINE
EXACERBATION OF SEIZURES IN CHILDREN BY CARBAMAZEPINE
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DOI：
10.1056/nejm198510103131503
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发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
HOSEY, LC
中科院分区：
文献类型：
--
作者：
SNEAD, OC;HOSEY, LC
我们研究了15名复杂部分性癫痫发作的儿童，其中一种或多种癫痫发作类型在卡马西平治疗期间加重。加重的最常见癫痫发作类型为全身性非典型失神（11例患者）。4例患者有更频繁和严重的全身性惊厥发作。视频脑电图遥测监测提示，脑电图可用于预测卡马西平致癫痫发作加重的风险。双侧同步棘波和慢波放电频率为2.5~3周/秒时，卡马西平可增加非典型失神发作的发生率，而全身棘波和慢波频率为1~2周/秒时，提示全身性惊厥发作的风险增加。特别是那些在脑电图上具有每秒2.5至3个周期的广义双侧同步放电的患者。对于任何伴随使用本抗惊厥药而出现全身惊厥或全身失神发作频率增加的儿童，应将本品视为可能的促发因素。（N Engl J Med 1985; 313：916 - 21.）
We studied 15 children with complex partial seizures in whom one or more seizure type was exacerbated during treatment with carbamazepine. The most common seizure type that was exacerbated was generalized atypical absence (11 patients). Four patients had more frequent and severe generalized convulsive seizures. Monitoring with video-electroencephalographic telemetry suggested that the electroencephalogram can be used to predict the risk of seizure exacerbation with carbamazepine. A bilaterally synchronous spike-and-wave discharge of 2.5 to 3 cycles per second is predictive of increased atypical absence seizures with carbamazepine, whereas generalized bursts of spikes and slow waves of 1 to 2 cycles per second suggest a risk of increased generalized convulsive seizures.Carbamazepine should be used with caution in children with a mixed seizure disorder, particularly those with a generalized bilaterally synchronous discharge of 2.5 to 3 cycles per second on the electroencephalogram. The drug should be considered a possible precipitating factor in any child with an increased frequency of generalized convulsive or generalized absence seizures concomitant with administration of this anticonvulsant agent. (N Engl J Med 1985;313:916–21.)