年1216日.pptVIP

贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 忘了服藥怎麼辦？ 原則上， 長效藥物當天或隔天都可以一起補服用 未預防濃度突然升高，造成不舒服，補服用之藥物宜與當天之原劑量間隔服用 若多天未服用，可先補一日劑量 若無法決定，可請教原主治醫師 * * 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 97 年 12 月 16 日 民眾醫院院長 部定副教授 張 淑 鳳 醫 師 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇症的診斷與治療 癲癇的定義 The epilepsies are a group of conditions marked by recurrent seizures (重複的發作), which are the clinical manifestations (臨床表癥) of abnormal brain electrical discharges (不正常之腦部發電). 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 Revised international classification of Epilepsies, epileptic syndromes and related seizure disorders 1、Localization-related (Focal, local, partial) 2、Generalized 3、Epilepsies undetermined whether focal or generalized 4、Special syndromes Situation-related seizure (情境相關) Febrile convulsion (熱痙攣) Isolated seizures or isolated status epilepticus Seizures occurring only with acute metabolic or toxic events due to factors such as alcohol, drugs, eclampsia, and nonketotic hyperglycemia (急性代謝性、毒性、子癇) 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇之藥物治療 傳統癲癇用藥 Phenytoin (Dilantin 100 mg 癲能停) Phenobarbital (Luminal 魯米拿) LA (Phenytoin 50mg, Luminal 20 mg) Carbamazepine (Tegretol, Carpin, Tegol Tegretol CR, 200mg 癲通) 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇之藥物治療 傳統癲癇用藥 Valproate (Depakine 200mg, Depakine choron Dipochron 500mg帝拔癲) Clonazepam (Rivotril 0.5mg, 2mg利福全) Clobazam (Frisium 10mg 福利寧) 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇之藥物治療 其他癲癇用藥 Diamox (250mg 丹木斯) 治療重複發作用藥 Diazepam (Valium, 煩寧, 5mg/ml; 10mg/amp ) Ativan (Lorazepam 2mg/ml, vial) Dormicum (Midaloram 5mg/ml, vial) Dilantin, Phenobarbital, Depakine 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇之藥物治療 第二線癲癇用藥 Lamotrigine (Lamictal 50mg,100mg 樂命達) Viagabatrin (Sabril 赦癲易) Gabapentin (Neurontin 100, 300, 400, 600 mg, Gaty 600mg 鎮頑癲) Topiramate (Topamax 25,50,100 mg妥泰) Levetiracetam (Keppra優閒) Oxcarbazepin (Trileptal 除癲達) Tiagabine (Gabitril 概別癲) 贵有恒何必三更眠五更起，最无益只怕一日曝十日寒 与君共勉 癲癇首選用藥（一） Carbamazepine (Tegretol) Initial dose