Türkan ACAR, Mehmet Fevzi ÖZTEKİN, Neşe ÖZTEKİN

Karbamazepin monoterapisine yanıt alınamayan parsiyel epilepsi hastalarında levetiracetam veya zonisamid ek tedavilerinin karşılaştırılması

Giriş ve Amaç: Parsiyel epilepsi en sık görülen nöbet tipi olup bazı hastalarda monoterapi ve hatta politerapiye rağmen yeterli nöbet kontrolü sağlanamayabilir. Bu çalışmadaki amacımız karbamazepin monoterapisi ile nöbet kontrolü sağlanamamış hastalarda levetirasetam veya zonisamid ekleme tedavilerinin etkinlik ve yan etki bakımından karşılaştırılması hedeflenmiştir. Gereç ve Yöntem: 18-54 yaş arası, en az 1 yıldır karbamazepin monoterapisi ile takip edilen 32 hasta çalışmaya alındı. Bu hastaların 16’sına zonisamid, 16’sına levetirasetam eklendi. Hastalar ekleme tedavisi sonrası sabit titrasyonda tutulacak şekilde 3 ay boyunca izlendi.Bulgular: Zonisamid eklenen grubun yaş ortalaması 33,4±10,6 (7 erkek, 9 kadın) iken levetirasetam grubunda 35,7±11,5 (8 erkek, 8 kadın) idi. Toplam nöbet sayıları bakımından 3 aylık izlem süresi değerlendirildiğinde her iki grup arasında etkinlik ve yan etki bakımından istatistiksel olarak anlamlı fark saptanmamıştır (p=0,377). Sonuç: Parsiyel nöbetlerin ekleme tedavilerinde levetirasetam veya zonisamid benzer oranda etkin olup nöbet kontrolü sağlanamayan hastalarda yan etki profilinin de az olması nedeniyle kullanılabilir.

Anahtar Kelimeler:

Levetirasetam, zonisamid, parsiyel epilepsi

Comparison of levetiracetam or zonicamide additional treatments in partial epilepsy diseases which karbamazepine monotherapy is not responded

Background and Aims: Partial epilepsy is the most common type of seizure and in some patients sufficient seizure control may not be achieved despite monotherapy and even polytherapy. Our aim in this study was to compare the efficacy and side effects of levetiracetam or zonisamide add-on treatments in patients without seizure control with carbamazepine monotherapy.Material and Method: Thirty-two patients aged 18-54 years who were followed for at least 1 year by carbamazepine monotherapy were included in the study. Zonisamide was added to 16 of these patients, and levetiracetam was added to 16 of these patients. Patients were monitored for 3 months to be held at constant titration after the insertion therapy.Results: The mean age of the group to which zonisamide was added was 33.4 ± 10.6 (7 males, 9 females) while the levetiracetam group had 35.7 ± 11.5 (8 males, 8 females). When 3-month follow-up period was evaluated in terms of total number of seizures, there was no statistically significant difference between the two groups in terms of efficacy and side effects (p = 0,377). Conclusion: Levetiracetam or zonisamide can be used in patients with partial seizures with similar side effects and fewer side effects in patients with seizure control.

Keywords:

Levetiracetam, zonisamide, partial epilepsy,

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