新人999原发性癫痫如何治疗配图，仅供参考
Primary generalized seizuresThe classification “primary generalized seizures” includes tonic–clonic seizures,absences,myoclonic seizures,clonic seizures,tonic seizures and atonic seizures . The registered (and reimbursed) indications of AEDs do not cover all these subtypes of primarily generalized seizures. Registered and reimbursed AEDs for monotherapy of primary generalized tonic–clonic seizures are carbamazepine,lamotrigine,phenobarbital,phenytoin,primidone,topiramate,and valproate. Primidone and valproate are registered and reimbursed for juvenile myoclonic epilepsy (Table ).
The authors consider valproate to be first choice for the treatment of primary generalized seizures,except in women of childbearing age. Lamotrigine,levetiracetam and topiramate are alternative first choices (Table ). The level of evidence for efficacy of the AEDs in the treatment of primary generalized seizures is not known. Clinical studies have focused on particular subtypes,such as primary generalized tonic–clonic seizures or JME. The efficacy of lamotrigine is best documented against primarily generalized tonic–clonic seizures,absence seizures,and drop attacks associated with Lennox–Gastaut syndrome . It is less effective than valproate in syndromes associated with myoclonic manifestations or absences,and may induce or aggravate myoclonic seizures. The efficacy of levetiracetam is best documented against primarily generalized tonic–clonic seizures,and myoclonic seizures ; information on its efficacy against tonic and atonic seizures is lacking. The efficacy of topiramate is best documented against primarily generalized tonic–clonic seizures and drop attacks associated with Lennox–Gastaut syndrome. There is no information available on the efficacy of topiramate against absence seizures.
Carbamazepine may be a valuable alternative first choice for the treatment of primary generalized tonic–clonic seizures,but is not effective for other types of primary generalized seizures,and may induce or aggravate myoclonic seizures and absences.","department":"
