[Dynamics of clinical, neurophysiological and radiological indices as a criterion for evaluation of treatment quality of symptomatic epilepsy with keppra and topamax].
A comparative analysis of treatment with keppra and topamax of various types of epilepsy has been carried out in 37 patients aged from 1 to 35 years. Symptomatic temporal-frontal-lobe epilepsy was diagnosed in 22 patients, symptomatic temporal lobe epilepsy in 15 including "urgent aid" cases with previous antiepileptic therapy being ineffective. Effect of the drugs on the cerebral blood flow was studied with the single proton emission CT. Keppra treatment was assigned to 20 patients in dosages varying from 500 to 2,500 mg (30-50 mg/kg/daily) for single intake. Then the patients received the drug two times daily under the clinical and EEG control. The drug was tested for using in the "urgent care mode". The clinical effect by 43% decreasing (p<0,001) of seizures was observed in the first 12 h. The "stability state" was 80% after 8 months of the treatment. Topamax was administered to 17 patients in two dosages depending on patient's age and weight starting with 25-50 mg (from 3 to 12,5 mg/kg/daily) with the dose adjustment during 2 days. The latter was depended on the dynamics of clinical data and EEG. For the first 2 days, patients revealed changes in seizures quality: the seizure structure became less complex, without generalized seizures, and period of a seizure was shorter. Reduction of seizures frequency was observed on the 7-10th day and made up on average 73,9% (p<0,01). Comparing to keppra, topamax did not cause signs of autonomic and psychological discomfort. Generalized seizures became less frequent by the 3rd day.
Shershever
A S
AS
Lavrova
S A
SA
Telegin
A V
AV
Grib
A V
AV
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D001783:Blood Flow Velocity / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D000077287:Levetiracetam; D008297:Male; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D000077236:Topiramate; D016896:Treatment Outcome
D000927:Anticonvulsants; D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose; D000077287:Levetiracetam; D010889:Piracetam