Valproate-induced parkinsonism in epilepsy patients
Valproate-induced parkinsonism in epilepsy patients
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DOI：
10.1002/mds.21188
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发表时间：
2007-01-01
影响因子：
8.6
通讯作者：
Tan, Eng-King
中科院分区：
文献类型：
--
作者：
Jamora, Dominic;Lim, Shih-Hui;Tan, Eng-King
我们系统地检查了三级转诊中心的 226 名癫痫患者，发现 6 名（5.04%）患有丙戊酸诱发的帕金森症。与服用其他抗癫痫药物的患者相比，接受丙戊酸治疗的患者组中帕金森病患者的患病率显着较高（119 名患者中的 6 名 [5.04%] 对比 107 名患者中的 0 名 [0%]；chi(2) = 5.54；P = 0.025）。这六名患者已服用丙戊酸超过 3 年（平均 75.67 +/- 25.32 个月），平均剂量为 750 +/- 273.86 毫克/天。丙戊酸剂量减少或停止，同时补充另一种抗癫痫药物。平均 UPDRS 运动评分从 10.67 +/- 5.1 显着提高至 4.75 +/- 2.75 (P < 0.05)。癫痫发作没有复发。在三级转诊中心工作的临床医生应对丙戊酸诱发的帕金森病保持高度怀疑。早期识别并改用另一种抗癫痫药物可能有助于减少这些患者不必要的痛苦。 (C) 2006 年运动障碍协会。
We systematically examined 226 epilepsy patients in a tertiary-referral center and found 6 (5.04%) to have valproate-induced Parkinsonism. There was a significantly higher prevalence of patients with Parkinsonism in the group of patients treated with valproate compared to those who were on other antiepileptic drugs (6 [5.04%] of 119 vs. 0 [0%] of 107; chi(2) = 5.54; P = 0.025). These six patients had been on valproate for more than 3 years (mean, 75.67 +/- 25.32 months) at an average dose of 750 +/- 273.86 mg/day. The valproate doses were decreased or discontinued with supplementation from another antiepileptic medication. The mean UPDRS motor score significantly improved from 10.67 +/- 5.1 to 4.75 +/- 2.75 (P < 0.05). There was no relapse of seizures. Clinicians working in tertiary-referral centers should have a high index of suspicion for valproate-induced Parkinsonism. Early recognition and switching into another antiepileptic medication may help reduce unnecessary suffering in these patients. (C) 2006 Movement Disorder Society.