The clinical features and functional impact of valproate-induced tremor
The clinical features and functional impact of valproate-induced tremor
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DOI：
10.1016/j.parkreldis.2017.09.011
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发表时间：
2017-11-01
影响因子：
4.1
通讯作者：
Fidel Baizabal-Carvallo, Jose
中科院分区：
文献类型：
--
作者：
Alonso-Juarez, Marlene;Torres-Russotto, Diego;Fidel Baizabal-Carvallo, Jose
背景：震颤是抗惊厥药（尤其是丙戊酸盐）的已知副作用。然而，有一个关于详细的临床特征和功能的影响丙戊酸盐引起的tremor.Methods：我们研究了一个队列的患者与抗惊厥药物治疗的神经系统疾病，通过盲法评价使用震颤临床评定量表（CRST）;我们比较了药物诱发震颤的频率、严重程度和功能影响，结果：从218例连续患者的队列中，171例进行了充分评价; 118例患者单独使用丙戊酸盐或与其他抗惊厥药物联合使用，53例患者正在使用其他抗惊厥药物。队列评价时的平均年龄（+/- SD）为32 ± 13岁，女性占病例的55.6%。在丙戊酸盐治疗患者中更常观察到震颤，特别是姿势性上肢震颤：49% vs. 15%（右侧）（P < 0.001）和48.3% vs. 13.2%（左侧），（P < 0.001）; CRST总分较高：12.14 vs. 3.06（P < 0.001），并且与服用其他抗惊厥药物的患者相比，需要更频繁地治疗药物诱导的震颤：23.7% vs. 5.6%（P=0.005）。在118例接受丙戊酸盐治疗的患者中，女性的CRST总分高于男性：14.54 +/- 14.9 vs. 9.56 +/- 9.55（P=0.034）。CRST总评分、丙戊酸盐每千克剂量和丙戊酸盐血清水平之间存在弱相关性，observed.Conclusions：在服用丙戊酸盐的患者中经常观察到震颤，约24%的病例严重到需要治疗。(C)2017爱思唯尔有限公司版权所有
Background: Tremor is a known side-effect of anticonvulsants, particularly of valproate. However, there is a dearth of information regarding detailed clinical features and functional impact of valproate-induced tremor.Methods: We studied a cohort of patients treated with anticonvulsants for neurological disorders, through blinded evaluations using the Clinical Rating Scale for Tremor (CRST); we compared the frequency, severity and functional impact of drug-induced tremor between, patients treated with valproate and those treated with other anticonvulsants.Results: From a cohort of 218 consecutive patients, 171 were fully evaluated; 118 patients were taking valproate alone or combined with other anticonvulsants and 53 patients were taking other anticonvulsants. Mean age (+/- SD) at evaluation of the cohort was 32 +/- 13 years, females represented 55.6% of cases. Tremor was more frequently observed in patients taking valproate particularly postural upper limb tremor: 49% vs. 15% (right-side) (P < 0.001) and 48.3% vs. 13.2% (left-side), (P < 0.001); had a higher total CRST score: 12.14 vs. 3.06 (P < 0.001), and required more frequently treatment for drug-induced tremor: 23.7% vs. 5.6% (P=0.005) compared with patients taking other anticonvulsants. Among 118 patients taking valproate, women had a higher total CRST score compared with men: 14.54 +/- 14.9 vs. 9.56 +/- 9.55 (P=0.034). A weak correlation between the total CRST score, dose per Kg of valproate and serum levels of valproate were observed.Conclusions: Tremor is frequently observed in patients taking valproate and is severe enough to require treatment in about 24% of cases. (C) 2017 Elsevier Ltd. All rights reserved.