Sechi Gianpietro, Cocco Giovanni A, D'Onofrio Marina, Deriu Maria G, Rosati Giulio
Neurological Clinic, Viale San Pietro 10, 07100 Sassari, Italy.
Epilepsy Behav. 2006 Nov;9(3):521-3. doi: 10.1016/j.yebeh.2006.08.005. Epub 2006 Sep 12.
The aim of this study was to evaluate the clinical effects of levetiracetam (LEV) in patients with partial epilepsy and disfluent speech.
Five consecutive patients with partial epilepsy and disfluent speech resulting from developmental or neurogenic stuttering were enrolled in a 9-week, open-label, prospective study. LEV was given in combination with carbamazepine (CBZ) or phenytoin (PHT) at dosages ranging from 500 to 1500mg twice daily. The severity of stuttering was assessed with the verbal fluency test (VFT), and with the patient global impression of improvement (PGI), at baseline and after 9weeks. Electroencephalography and serum monitoring of CBZ and PHT levels were done before and after the study. Seizure frequency was monitored.
After LEV therapy, verbal fluency for all patients, as measured by the VFT, improved from 25% at baseline to 64%, as did the speed of oral reading, from 5 to 23%. On the PGI, all patients rated themselves as better and as having less disfluent speech after LEV therapy. For four patients with incomplete control of their seizures, the seizure count decreased by more than 50% after LEV therapy. The beneficial effect of LEV on verbal disfluency demonstrated on the PGI persisted for the entire period of observation, which ranged from 7 to 11 months.
As an add-on therapy, LEV seems to improve verbal fluency in patients with partial epilepsy and disfluent speech. This effect seems unrelated to the antiepileptic activity of the drug. A placebo-controlled trial of LEV in patients with this kind of verbal disfluency is warranted.
本研究旨在评估左乙拉西坦（LEV）对部分性癫痫伴言语不流畅患者的临床疗效。
连续纳入5例因发育性或神经性口吃导致部分性癫痫伴言语不流畅的患者，进行为期9周的开放标签前瞻性研究。LEV与卡马西平（CBZ）或苯妥英（PHT）联合使用，剂量为每日两次，每次500至1500mg。在基线和9周后，通过言语流畅性测试（VFT）和患者总体改善印象（PGI）评估口吃的严重程度。在研究前后进行脑电图检查以及CBZ和PHT水平的血清监测。监测癫痫发作频率。
LEV治疗后，通过VFT测量，所有患者的言语流畅性从基线时的25%提高到64%，朗读速度也从5%提高到23%。在PGI上，所有患者在LEV治疗后都认为自己情况更好，言语不流畅程度减轻。对于4例癫痫控制不完全的患者，LEV治疗后癫痫发作次数减少了50%以上。LEV对言语不流畅的有益作用在PGI上得到证实，并在7至11个月的整个观察期内持续存在。
作为一种附加疗法，LEV似乎可改善部分性癫痫伴言语不流畅患者的言语流畅性。这种效果似乎与该药物的抗癫痫活性无关。有必要对LEV在这类言语不流畅患者中进行安慰剂对照试验。
