小児の部分発作に対するclonazepam単剤治療の効果 Clonazepam Monotherapy in the Control of Partial Seizures in Children

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過去に2回以上の部分発作を示す, 潜因性局在関連性てんかんの患児40例を対象に, clonazepam (CZP) 単剤治療を行い, 最初の12か月間発作が完全に抑制された30例について, その後の経過を観察した. CZPの初回維持量は0.1mg/kg/dayを基準とし, 治療期間は2年9か月~7年7か月 (平均5年2か月) にわたる.<BR>30例のうち, 5例怠薬時に発作が出現したが, 維持量継続期間中に発作が再現して, CZPの単剤治療を断念したものは2例のみであった. この2例と途中転居によりその後の経過を観察し得なかった3例を除く25例中21例では, 最終的に5年間発作が抑制され, 脳波上突発性発射が消失し, 減量期間を経て断薬を試みたが, このうち5例に反跳発作を認め, 1例は断薬後に再発した. 4例はCZP単剤治療を継続中である.<BR>脳波所見は, 投薬開始後6か月の時点で30例中22例 (73.3%), 24か月の時点で27例 (90.0%) で突発性発射が消失していた.<BR>小児の部分発作に対するCZP単剤治療の効果は優れているが, 怠薬, 断薬時の反跳発作には十分注意すべきと考える.

The long-term outcome of epilepsies were investigated in a prospective randomized study when clonazepam (CZP) was given as a single drug to children with cryptogenic localization-related epilepsies.<BR>The first group of patients comprised 40 previously untreated children aged 3 to 14 years (mean, 8 years and 6 months) with any types of partial seizures, who had been newly reffered to our pediatric seizure clinic. A daily dose of 0.025mg/kg of CZP was introduced and the dosage was increased gradually to the initial maintenance daily dose of 0.1mg/kg. Of the total 40 patients seizures were not controlled in 6 with CZP monotherapy. Seizures increased in 2 and behavior changes requiring discontinuance of the drug occurred in another 2 patients.Of the remaining 30 patients, in whom seizures were controlled for the first 12 months, and CZP monotherapy was continued for a median of 5 years and 2 months, 28 patients remained seizure-free with the maintenance dosage, excluding a recurrence of seizures related to non-compliance of medication in 5 patients. In 16 out of the 28 patients, whose seizures were controlled with CZP monotherapy, the drug therapy was successfully discontinued except in one, in whom seizure recurred 6 months after stopping the therapy. However, in the other 5 patients withdrawal seizures ocurred during decreasing the maintenance dosage or soon after stopping the therapy.<BR>The long-term outcome of epileptic children with partial seizures treated with CZP monotherapy is excellent, but the attention should be paied for the extreme sensitivity to the development of generalized tonic-clonic seizures on withdrawal of the drug.

収録刊行物

  • てんかん研究 = Journal of the Japan Epilepsy Society

    てんかん研究 = Journal of the Japan Epilepsy Society 14(2), 116-122, 1996-06-30

    一般社団法人 日本てんかん学会

参考文献:  16件中 1-16件 を表示

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各種コード

  • NII論文ID(NAID)
    10008555641
  • NII書誌ID(NCID)
    AN10043823
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09120890
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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