Benzodiazepine系抗てんかん剤clonazepamの抗てんかん作用について（Ⅱ）—Clonazepam静注脳波からみた抗てんかん作用

ANTIEPILEPTIC ACTIVITY OF CLONAZEPAM:A BENZODIAZEPINE ANTIEPILEPTIC Ⅱ. EFFECTS OF INTRAVENOUS INJECTION OF CLONAZEPAM

I．はじめに

　著者らは前報^9）においてbenzodiazepine系抗てんかん剤であるclonazepamの効果と特徴について論じた。今回は，さらにその治療的特徴を明らかにするため，発作間歇期に発作性異常波を認めたてんかん患者にclona—zepam静注を試み，静注脳波からclonazepamの抗てんかん作用について検討を行なつた。静注による脳波像の変化は短時間ではあるが，clonazepamの作用が直接脳波上に反映されることにより，clonazepamの抗てんかん作用について若干の知見が得られたたので，その結果を報告する。

　なお，発作重積状態4例に対するclonazepam静注の治療効果についてもあわせて報告する。

Clonazepam, a new anti-epileptic agent was intra-venously injected into 23 patients with paroxysmal activity in the interictal period and anti-epileptic effects of clonazepam were evaluated in terms of changes in EEG.

1) There was little influence on the basic rhythm with improvement observed only in 4 cases (19%). As there was a case which was aggravated by clonazepam therapy showing a trend toward slow waves on EEG, the paradoxical possibility of clonazepam for clinically inducing seizures was discussed.

2) Generalized paroxysmal waves were restrained with clonazepam in 81. 8% of the subjects. It was shown that clonazepam was more intensive in the effect restraining generalized paroxysmal waves than focal paroxysmal waves.

3) Clonazepam was remarkably effective on 4 cases out of 6 with temporal spike. The effect of clonazepam on this kind of waves was described. 4) Clonazepam was effective on all cases with photosensitivity. Based on the findings, it was emphasized that clonazepam exerts strong restrain-ing effects on photosensitivity.

5) Based on the comparison with the effects of the intravenously administered diazepam in 5 cases, it was proved that the effect of clonazepam is maintained longer than that of diazepam.

6) In some half number of the subjects, muscle relaxation and drowsiness were induced as adverse reactions. The blood pressure was found lowered by roughly 10%.

7) Satisfactory therapeutic results were obtained with the intravenously administered clonazepam in 4 cases with status epilepticus.