Abstract
In this study, we have evaluated the efficacy of a concomitant therapy of CBZ with PB on 10 patients who had been treated with conventional polytherapy of anticonvulsants without satisfactory control, and also resistant further to CBZ alone or higher dose of multiple anticonvulsants including CBZ.
The average age of these 10 patients (4 males and 6 females) was 36.2±15.5 old. The average age of initial onset was 14.4±13. 7 old. Their type of seizures was complex partial seizure in all of them.
Results:
(1) As to the therapeutic results of concomitant therapy of CBZ with PB, the complete disappearance of clinical seizures was observed in one patient, reduction of the frequency by more than 75% in one, reduction by more than 50% in one and no response in 7.(2) As to the electroencephalogram (EEG), abnormal (epileptiform) EEG discharges disappeared in 2 patients. In one of them, seizures disappeared completely and in another, they were controled by more than 75%. Eight patients showed no change.(3) Relevant past history and abnormal CT-scan were not observed in these with improvement, but present in 4 out of the 7 patients without response.(4) The average dose of PB was 100 mg/day (its plasma concentrations 15.3 μg/m) in the clinically improved patients, 200 mg/day (its plasma concentration 31.3 μg/m) in the patient with a reduction of the seizure frequency of more than 75%, 150 mg/day (34.5 μg/m/) in the patient with the reduction of more than 50%, and 214 mg/day (30.8 μg/ml) in the 7 patients who did not respond to the therapy.
This study revealed that a concomitant therapy of CBZ with PB was effective in 30% of the patients with complex partial seizures which were resistant to mono-therapy of CBZ. Our study sugests further consideration of efficacy of a concomitant therapy with two drugs of a various type.
