Lamotrigine as first-line drug in childhood absence epilepsy: a clinical and neurophysiological study
Lamotrigine as first-line drug in childhood absence epilepsy: a clinical and neurophysiological study
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DOI：
10.1016/s0387-7604(03)00090-1
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发表时间：
2004-01-01
影响因子：
1.7
通讯作者：
Pascotto, A
中科院分区：
文献类型：
--
作者：
Coppola, G;Licciardi, F;Pascotto, A
为了调查拉莫三嗪 (LTG) 作为单一疗法治疗新诊断的儿童失神发作的有效性和耐受性，其次评估该药物对昼夜节律发作间期全面性癫痫样放电的疗效，连续 20 名新诊断的儿童失神癫痫患者（5 名男性，15 名女性），年龄 3-10 岁（平均 6.9 岁），将 LTG 作为一线药物给药初始剂量为 0.5 mg/kg/天，持续 2 周，随后以 1.0 mg/kg/天的剂量再持续 2 周。此后，根据临床反应，剂量以 1 mg/kg/天的增量增加至 9-12 mg/kg/天。每名患者在开始 LTG 治疗前（时间 0）和 LTG 滴定结束维持期间（时间 1）均接受动态（24 小时）EEG 监测。经过平均 10.8 个月（范围 3 -28 个月）的随访期后，11 名儿童（55.5%）获得了 100% 癫痫发作控制，4 名（20%）儿童癫痫发作减少超过 75%，5 名（25%）儿童癫痫发作减少 > 50%，对照组的平均 LTG 剂量为 6.2 mg/kg/天（范围 1.2-11）。三名患者（15%）出现不良事件；它们通常是轻微且短暂的。我们的系列研究证实，LTG 单一疗法可以控制大约一半儿童的典型儿童失神发作，并且可以减少无癫痫发作和不受控制的患者的发作间期全身性棘波放电。由于皮疹的风险，药物的缓慢滴定阶段可能最终会降低依从性。 (C) 2003 Elsevier B.V. 保留所有权利。
To investigate to which extent lamotrigine (LTG) may be effective and tolerated as a monotherapy for the treatment of newly diagnosed childhood absence seizures and, secondly, to evaluate the efficacy of this drug on the circadian interictal generalized epileptiform discharges, 20 consecutive newly diagnosed patients (five males, 15 females), aged 3-10 years (mean 6.9 years), affected by childhood absence epilepsy, were administered LTG as first-line drug at the initial dose of 0.5 mg/kg/day for 2 weeks, followed by 1.0 mg/kg/day for an additional 2 weeks. Thereafter, doses have been increased in 1-mg/kg/day increments up to 9-12 mg/kg/day in accordance with the clinical response. Each patient underwent an ambulatory (24 h) EEG monitoring before starting LTG therapy (time 0) and during the maintenance period at the end of LTG titration (time 1). After a mean follow-up period of 10.8 months (range 3 -28 months), a 100% seizure control was obtained in I I children (55.5%), a more than 75% seizure decrease was present in four (20%), and a > 50% seizure decrease in five (25%), with a mean LTG dose of 6.2 mg/kg/day (range 1.2-11) in the controlled group. Adverse events were present in three patients (15%); they were generally mild and transient. Our series confirms that LTG monotherapy may control typical childhood absence seizures in about half the children as well as it may decrease interictal generalized spike and wave discharges both in seizure-free and uncontrolled patients. The slow titration phase of the drug due to the risk of the skin rash may eventually reduce compliance. (C) 2003 Elsevier B.V. All rights reserved.