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For the control of secondarily generalized tonic-clonic seizures, carbamazepine and valproate were comparably effective(in 136 patients and 138 patients,respectively).For complex partial seizures,four of five outcome measures favored carbamazepine(100 patients)over valproate(106 patients):the total number os seizures(2.7 vs 7.6,P=0.05),the number of seizures per month(0.9 vs 2.2,P=0.01),the time to the first seizure(P<0. 02),and the seizure-rating score(P=0.04).Carbamazepine was also superior according to a composite score that combined scores for the control of seizures and for adverse effects(P<0.001).Valproate was associated more frequently than carbamazepine with a weight gain of more than 5.5 kg(12 lb)(20 percent vs.8 percent,P<0.001),with hair loss or change in texture (12 percent vs.6 percent,P<0.001).Rash was more often associated with carbamazepine(11 percent vs.1 percent,P<0.001).Conclusions.Valproate is as effective as carbamazepine for the treatment of genrealized tonic-clonic seizures,but carbamazepine provides better control of complex partial seizures and has fewer long-term adverse effects. |
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adverse drug reaction carbamazepine hair,loss seizure seizure,focal seizure,psychomotor-temporal lobe seizure,treatment of sodium valproate treatment of neurologic disorder tremor weight gain
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