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| 拉考沙胺加重伴有获得性脑结构异常的癫痫发作的研究 |
| Lacosamide aggravates epilepsy with acquired brain structural abnormalities |
| 投稿时间：2025-07-22 修订日期：2025-07-22 |
| DOI： |
| 中文关键词: 拉考沙胺 脑结构异常 局灶性癫痫 |
| 英文关键词: lacosamide brain structural abnormalities focal epilepsy |
| 基金项目:医务人员培养助推项目：勾织物电极替代传统脑电电极的可行性研究（2024HLJS17） |
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| 中文摘要: |
| 目的 对癫痫患者添加拉考沙胺治疗后癫痫发作加重的病例进行分析。方法 收集空军军医大学西京医院神经内科脑电监测中心收治的4例接受拉考沙胺治疗后出现癫痫发作加重的病例，分析其临床和电生理特征。结果 4例患者的癫痫发作起始年龄为8-38岁，男性3例。均为局灶性起源癫痫且接受手术治疗，2例为额叶胶质瘤切除术，1例为脑外伤后去骨瓣减压术，1例为药物难治性癫痫多次行癫痫灶切除。4例患者术后接受拉考沙胺治疗的年龄为24-57岁，均出现原有局灶性癫痫发作加重，包括发作性头眼右转、面部抽搐、失语和偏侧面部感觉异常发作等。结论 对于有颅脑手术史的癫痫患者，拉考沙胺可能加重原有的局灶性癫痫发作。拉考沙胺导致癫痫发作加重的机制有待进一步明确。 |
| 英文摘要: |
| Objective To evaluate clinical and electrophysiological features of epilepsy patients with worsening seizures following lacosamide treatment. Methods The clinical and electrophysiological characteristics of 4 patients with worsening seizures after lacosamide treatment in epilepsy Center of the Department of Neurology, Xijing Hospital, Air Force Military Medical University were analyzed. Results All the four patients had their first seizure at the age of 8-38 years, three were male. They were all diagnosed as focal epilepsy and received brain surgery, two patients underwent surgical treatment for frontal lobe glioma, one patient underwent surgical treatment after brain trauma, and one patient underwent multiple surgical treatment for drug-resistant epilepsy. They received lacosamide treatment at the age of 24-57 years, and worsening seizures were characterized by paroxysmal right strabismus of the eye and head tilt to the right, facial twitching, aphasia and hemilateral facial paresthesia. Conclusion Lacosamide may aggravate the original focal seizures in epilepsy patients with a history of brain surgery. The mechanism of seizure exacerbation caused by lacosamide needs to be further clarified. |
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