Objective assessment of neurotoxicity while shifting from carbamazepine to oxcarbazepine
Objective assessment of neurotoxicity while shifting from carbamazepine to oxcarbazepine
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DOI：
10.1046/j.1600-0404.2003.00234.x
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发表时间：
2004-05-01
影响因子：
3.5
通讯作者：
Nagy, Z
中科院分区：
文献类型：
--
作者：
Clemens, B;Ménes, A;Nagy, Z
目的-客观评估卡马西平（CBZ）与奥卡西平（OXC）在难治性部分性癫痫患者中的非明显神经毒性，这些患者对CBZ治疗耐药，并从CBZ单药治疗转换为OXC单药治疗。材料和方法-在20名成人患者中比较治疗等效剂量（每100 mg CBZ 150 mg OXC）。在两种治疗条件下进行神经病学调查，常规和频谱EEG分析，脑干听觉诱发反应（BAER）。20名年龄匹配的健康对照的EEG和BAER数据有助于解释。对主要目标变量（电生理参数）进行盲法评价。结果-治疗条件之间在神经系统状况、缺乏临床明显神经毒性、癫痫发作频率和EEG尖峰频率方面无显著差异。与CBZ治疗相比，OXC治疗的特点是δ、θ和α功率更小，β功率更大，平均α频率显著更高（左枕和右枕导联分别为P = 0.03和0.05）。与正常组（P = 0.01）和OXC组（P = 0.02）相比，CBZ组的峰间潜伏期延长。结论-在该患者队列中，OXC替代CBZ与电生理参数的显著正常化相关，表明从CBZ转换为OXC单药治疗时神经毒性降低。
Objectives - Objective assessment of non-overt neurotoxicity of carbamazepine (CBZ) vs oxcarbazepine (OXC) in patients with difficult-to-treat partial epilepsy, who were resistant to CBZ treatment and were converted from CBZ monotherapy to OXC monotherapy. Material and methods - Therapeutically equivalent doses (150 mg OXC for every 100 mg CBZ) were compared in 20 adult patients. Neurological investigation, conventional and spectral EEG analysis, brainstem auditory evoked responses (BAER) were carried out in both treatment conditions. EEG and BAER data of 20 age-matched healthy controls helped interpretation. Primary target variables (electrophysiological parameters) were evaluated blindly. Results - There were no significant differences between treatment conditions concerning the neurological condition, lack of clinically evident neurotoxicity, seizure frequency and EEG spike frequency. OXC treatment was characterized by less delta, theta, and alpha power, more beta power, and significantly greater mean alpha frequency (P = 0.03 and 0.05 for the left and right occipital leads, respectively), than CBZ treatment. Interpeak latencies were prolonged in the CBZ condition as compared with normals (P = 0.01) and OXC (P = 0.02). Conclusion - In this cohort of patients substitution of OXC for CBZ was associated with significant normalization of electrophysiological parameters, indicating decreasing neurotoxicity while shifting from CBZ to OXC monotherapy.