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目的:为了探讨经丙戊酸治疗不满意的儿童癫痫,改用托吡酯治疗的疗效和安全性。方法:凡符合复杂部分性发作、部分继发全身性发作和Lennox-Gastau综合征。已服用丙戊酸1年,且其已达常规治疗剂量,其血药浓度已达有效范围,但控制不满意,月发作频度≥1次,CT与MRI未见颅内占位性病变、血管畸形或退行性病改用托吡酯治疗。结果:托吡酯治疗剂量可因不同类型而异,本组75例完全控制占38.7％,总有效率占82.7％,不良反应轻。结论:托吡酯对已用丙戊酸治疗不满意病例添加治疗或逐渐更换丙戊酸治疗可以有效。
Objective: To investigate the treatment of children with valproate unsatisfactory epilepsy, switch to topiramate treatment efficacy and safety. Methods: Those who meet the complex partial seizures, and some secondary systemic seizures and Lennox-Gastau syndrome. Has taken valproate for 1 year, and has reached the conventional treatment dose, the plasma concentration has reached an effective range, but the control is not satisfied, the frequency of monthly seizures ≥ 1 times, CT and MRI no intracranial space-occupying lesions, Vascular deformity or degenerative disease with topiramate treatment. Results: Topiramate treatment dose may vary with different types, 75 cases of complete control accounted for 38.7%, the total effective rate was 82.7%, adverse reactions were mild. CONCLUSIONS: Topiramate is effective in patients who have been dissatisfied with valproic acid treatment or in the gradual replacement of valproate.