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一例8岁男孩,7岁开始有间歇性凝视发作.诊断为单纯失神性癫痫.开始用乙琥胺与苯巴比妥治疗,发作频率无明显减少.11周后加用丙戊酸10mg/kg/日,发作次数减少一半.增量达30mg/kg/日,(750mg/日)发作完全控制.乙琥胺与苯巴比妥逐步减量,大约2周内停用.5周后,患者发生了剧烈的痉挛性上腹疼痛,放射至背部,餐后加重.发生前无外伤史.体检发现普遍性上腹压痛.血清淀粉酶1200单位(正常=14-18单位).诊断为胰腺炎.住院治疗后3天内胰腺炎逐渐消退.由于以前未有关于服用丙戊酸伴发胰腺炎的报导,治疗继续.4天后病人在低脂饮食的情况下出院.以后在3周过程中,血清淀粉酶恢复到155单位(正常=45-200单位/dl).病人无症状.6个月后复诊发现患儿有弥漫性脱发,痉挛性腹痛复发.血清淀粉酶398单位/dl(正常45-200单位/dl).再次入院.停用丙戊酸,重新
An 8-year-old boy, with intermittent gaze onset at the age of 7 years, was diagnosed as dementia epilepsy with no significant reduction in frequency of seizures starting with ethosuximide and phenobarbital, and after 11 weeks valproate 10 mg / kg / Day, the number of seizures reduced by half. Increases up to 30mg / kg / day, (750mg / day) seizures complete control.Ethylsuccin and phenobarbital gradually reduced, about 2 weeks to disable .5 weeks later, patients A severe spasmodic upper abdominal pain occurred, radiation to the back, postprandial aggravate .Before the occurrence of a history of trauma .Understanding of the general abdominal tenderness serum amylase 1200 units (normal = 14-18 units.) Diagnosis of pancreatitis . The pancreatitis gradually subsided within 3 days of hospitalization and treatment continued without reports of valproic acid-associated pancreatitis.4 days later the patient was discharged on a low-fat diet and thereafter at 3 weeks later serum The amylase returned to 155 units (normal = 45-200 units / dl). The patient was asymptomatic. Six months after the visit, he found diffuse alopecia and recurrent spasmodic abdominal pain. Serum amylase 398 units / dl (normal 45- 200 units / dl). Admission again. Disable valproic acid and re-enter