양성 소아 부분 뇌전증의 치료:중심측두엽 극파를 동반한 양성 소아 부분뇌전증에서의 저용량 Topiramate 저녁 1회 요법 투약 효과
Treatment of Benign Epilepsy with Centrotemporal Spikes: Effectiveness of Low-dose Topiramate at night therapy in Benign Epilepsy with Centrotemporal Spikes
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목적:BECTS는 예후가 양호하여,약물투여의 부작용을 고려한 최소한의 치료가 요구되는 질환이다 . 본 연구에서는 TPM1회 요법의 치료효과와 유용성을 알아보고자 하였다 . 방법:2009년 8월부터 2014년 7월까지 BECTS로 진단되어 저용량(25 mg) TPM을 저녁 1회 투여하여 18개월 이상 외래에서 추적 관찰하였던 23명 (남 13, 여 10)의 경과와 2003년 1월부터 2010년 11월까지 전남대학교병원 소아청소년과에서 BECTS로 진단하여 OXC를 투여하였던 63명(남34,여29)의 기록을 검토하였다 . 결과:저용량 TPM 1회 요법을 시행하였던 23명 중 18명 (78.2%)이 발작이 조절되었고 5명(21.8%)은 OXC을 추가하여 발작이 조절되었다.OXC 투여군 63명중 46명(73.1%)은발작이 조절되었으며,이중 5 명은 투약기간이 길어져 저용량 TPM으로 교체하였다 . 17명 (26.9%) 은 다른 항경련제 (TPM 13명, LTG 4명)를 추가하여 발작이 조절되었다. 저용량 TPM 1회 요법에서 뇌파 검사가 정상화되는 기간이 더 짧았다 . 부작용은 OXC 투여군은 7명 (피부발적 3, 체중증가 3, 기억력감퇴1)에서,저용량 TPM 1회 요법군은 1명(땀감소1)에서 나타났다 . 결론:BECTS 환자에게서 저용량 TPM 저녁 1회 요법은 OXC 치료와 비슷한 치료효과를 보이며 부작용이 없고 복용의 간편성을 고려하여 추천할만한 치료방법의 하나로 사료된다 .
Abstract
Purpose: Benign epilepsy with centrotemporal spikes (BECTS) is a benign disease which requires treatment with minimal side effects. The purpose of this study is to evaluate the effectiveness and efficacy of low dose topiramate (TPM), single dose, at night therapy. Method: We have reviewed the results of low dose TPM, single dose, at night therapy in BECTS who were treated from Oct. 2009 to Jul. 2014, and compared that with those of the treatment with oxcarbazepine (OXC) from Jan. 2003 to Nov. 2010. Results: Among the patients with single dose of TPM (n=23), the symptoms of 18 patients (78.2%) were controlled with TPM only and 5 patients (21.8%) were controlled with TPM with OXC. Among the patients with OXC therapy (n=63), the symptoms of 46 patients (73.1%) were controlled. Among these patients, 5 patients were converted to TPM therapy for the continued electroencephalogram (EEG) abnormality. The symptoms of 17 patients (26.9%) were controlled with add on therapy (TPM in 13 patients and Lamotrigine in 4). The duration of nomalized EEG of TPM therapy was shoter than those of OXC therapy. The side effects of OXC were skin rash in 3, weight gain in 3, and decreased memory in 1 patient. In TPM patients, decreased sweating was reported in 1 patient. Conclusion: In BECTS patients, single, low dose of TPM is as effective as OXC therapy. Also, it has better compliance with lesser side effects.
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