Aeby Alec, Poznanski Nathalie, Verheulpen Denis, Wetzburger Catherine, Van Bogaert Patrick
Department of Pediatric Neurology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Epilepsia. 2005 Dec;46(12):1937-42. doi: 10.1111/j.1528-1167.2005.00337.x.
To assess the add-on efficacy of levetiracetam on the EEG, behavior, and cognition of children with continuous spikes and waves during slow sleep (CSWS).
Charts of children with behavioral and/or cognitive deterioration associated with CSWS who received levetiracetam at 50 mg/kg/day as add-on treatment were retrospectively reviewed. Awake and sleep EEG recordings and detailed neuropsychological and behavioral assessments were available at baseline and 2 months after levetiracetam initiation. In children showing clinical and/or electrophysiological improvement after 2 months, levetiracetam was continued with a new evaluation at 1 year.
Twelve patients were included (9 cryptogenic and 3 symptomatic cases). Seven patients (58.3%) showed improvement of EEG record. Among these seven patients, neuropsychological evaluation was improved in three, and in the other four patients, not testable because of severe cognitive impairment, behavior was improved. Two patients improved in neuropsychological evaluation despite the lack of EEG improvement. Eight patients (66.6%) continued levetiracetam treatment after 2 months. After 1 year, four patients were still on levetiracetam, two because sustained effect on EEG and behavior and the two others because improvement in neuropsychological testing despite unchanged EEG. Levetiracetam was discontinued in the other four patients because of neuropsychological or behavioral deterioration associated with CSWS pattern, between 9 and 11 months after treatment initiation.
This retrospective study suggests that levetiracetam has a positive effect on the EEG, the behavior, and the cognition of patients with epilepsy and CSWS. Additional studies are warranted in order to assess the place of this drug in these epileptic conditions.
评估左乙拉西坦对慢波睡眠期持续棘慢波（CSWS）儿童脑电图、行为及认知功能的附加治疗效果。
回顾性分析因CSWS导致行为和/或认知功能恶化且接受50mg/kg/天左乙拉西坦附加治疗的儿童病历。在基线期及左乙拉西坦治疗开始后2个月，可获得清醒和睡眠脑电图记录以及详细的神经心理学和行为评估。在2个月后显示临床和/或电生理改善的儿童中，继续使用左乙拉西坦治疗，并在1年时进行新的评估。
纳入12例患者（9例隐源性和3例症状性病例）。7例患者（58.3%）脑电图记录有改善。在这7例患者中，3例神经心理学评估有所改善，另外4例因严重认知障碍无法进行测试，但行为有所改善。2例患者尽管脑电图无改善，但神经心理学评估有所改善。8例患者（66.6%）在2个月后继续接受左乙拉西坦治疗。1年后，4例患者仍在使用左乙拉西坦，2例是因为对脑电图和行为有持续效果，另外2例是因为尽管脑电图无变化，但神经心理学测试有所改善。另外4例患者在治疗开始后9至11个月因与CSWS模式相关的神经心理学或行为恶化而停用左乙拉西坦。
这项回顾性研究表明，左乙拉西坦对癫痫合并CSWS患者的脑电图、行为和认知功能有积极影响。有必要进行更多研究以评估该药物在这些癫痫病症中的地位。
