癫痫指南和共识解读课件

指南和专家共识回顾与解读NICE指南（2004年）是英国国家临床最佳研究所公布的权威的、全面的、可靠的临床抗癫痫药物指南英国健康协会指南（1999年）ANN指南（2004年）是美国神经病学会公布的旨在评估新型抗癫痫药物的指南

WelcometotheNationalInstituteforHealth

andClinicalExcellencewebsite

NICEistheindependentorganizationresponsibleforproviding

nationalguidanceonthepromotionofgoodhealthand

thepreventionandtreatmentofillhealth.On1April2005NICEjoinedwiththeHealthDevelopmentAgencytobecome

thenewNationalInstituteforHealthandClinicalExcellence

(alsotobeknownasNICE).

ClinicalExcellence

PublicHealthExcellence

NICEwassetupasaSpecialHealthAuthorityforEnglandandWaleson1April1999.Itsroleistoprovidepatients,healthprofessionalsandthepublicwithauthoritative,robustandreliableguidanceoncurrent‘bestpractice’.

(.uk/)NICE指南中抗癫痫药物单药治疗全面性癫痫的选用原则

首选药物次选药物避免药物失神发作丙戊酸钠，乙琥胺拉莫三嗪，托吡酯卡马西平，加巴喷丁，替加宾，氨己烯酸肌阵挛发作丙戊酸钠拉莫三嗪，左乙拉西坦，托吡酯卡马西平，加巴喷丁，替加宾，氨己烯酸强直－阵挛发作丙戊酸钠左乙拉西坦，托吡酯

失张力发作丙戊酸钠，拉莫三嗪左乙拉西坦，托吡酯

NationalInstituteofClinicalExcellence.NICE指南中抗癫痫药物单药治疗部分性癫痫的选用原则

首选药物次选药物单纯部分性发作卡马西平，拉莫三嗪，奥卡西平，丙戊酸钠加巴喷丁，左乙拉西坦，苯妥英，替加宾，托吡酯复杂部分性发作伴或不伴全身性发作卡马西平，拉莫三嗪，奥卡西平，丙戊酸钠加巴喷丁，左乙拉西坦，苯妥英，替加宾，托吡酯NationalInstituteofClinicalExcellence.英国健康协会指南UKMinistryofHealthScottishIntercollegiateGuidelinesNetworkDrugofFirstChoiceSecondChoiceDrugDrugstoAvoid失神ValproateEthosuximideLamotrigineCarbamazepinePhenytoin典型失神Valproate----肌阵挛发作ValproateLamotriginePhenobarbitalPrimidone--强直-阵挛发作ValproateLamotriginePhenobarbitalPrimidone--失张力发作Valproate----UKMinistryofHealth.May1999.ScottishIntercollegiateGuidelinesNetwork.Edinburgh:1997.英国健康协会指南UKMinistryofHealthScottishIntercollegiateGuidelinesNetworkDrugofFirstChoiceSecondChoiceDrugDrugstoAvoidSimplepartialCarbamazepineValproatePhenytoinLamotrigine--ComplexpartialCarbamazepineValproatePhenytoinLamotrigine--SecondarygeneralizedCarbamazepineValproatePhenytoinLamotrigine--UKMinistryofHealth.May1999.ScottishIntercollegiateGuidelinesNetwork.Edinburgh:1997.KarceskiSetal.EpilepsyBehav2005;7:s.Usuallynot

appropriateEquivocalUsually

appropriateValproate

Lamotrigine

Topiramate

Levetiracetam

Zenisanide

Phenytoin

Oxcarbazepie

Carbamazepie

Phenobarbital**2001Results2005Results2001年vs.2005年研究结果：

全面强直阵挛性癫痫95%ConfidenceIntervals2005Results

Tr,of 1st 2nd 3rdN Av.(SD) Chc line line line42 8.5(0.9) 73 95 5 042 8.1(1.0) 48 98 2 041 7.4(1.1) 20 83 17 042 6.7(1.7) 7 69 26 541 6.6(1.8) 12 61 3