Rosati Anna, Buttolo Luciano, Stefini Roberto, Todeschini Alice, Cenzato Marco, Padovani Alessandro
Paediatric Neurology Unit, Children's Hospital A. Meyer, University of Firenze, Viale Pieraccini 24, 50139 Firenze, Italy.
Arch Neurol. 2010 Mar;67(3):343-6. doi: 10.1001/archneurol.2009.335.
To evaluate the efficacy and safety of levetiracetam in the management of epilepsy in patients with glioma.
A prospective study in hospitalized patients with a new diagnosis of glioma.
Department of Neurological Sciences and Visions, Spedali Civili of Brescia.
From March 1, 2006, until January 1, 2009, 176 consecutive patients (101 men and 75 women) with a first diagnosis of glioma were enrolled in the study. All patients with a diagnosis of epilepsy were treated with levetiracetam.
Clinical, histological, and magnetic resonance imaging findings were analyzed.
Age at the diagnosis of glioma ranged from 22 to 79 years (mean [SD], 57 [15] years; median, 59 years). Duration of the disease ranged from 27 days to 2(1/2) years (mean [SD], 13.7 [7.8] months; median, 13 months). Eighty-two patients received levetiracetam because of a diagnosis of epilepsy. At the last evaluation (May 1, 2009), 75 of 82 patients (91%) treated with levetiracetam were seizure free; in 2 of these patients, levetiracetam was withdrawn because of intolerable adverse effects. Prompt and long-lasting control of seizures was obtained in 49 of 82 patients (60%) with a dose of levetiracetam that ranged from 1500 to 3000 mg/d, and 9 (11%) of the treated patients needed an increase of levetiracetam dosage to 4000 mg/d to become seizure free. No laboratory abnormalities were observed in patients with concomitant chemotherapy.
The results of this study provide good evidence that levetiracetam is efficacious and safe in patients with epilepsy due to glioma.
评估左乙拉西坦治疗胶质瘤患者癫痫的疗效和安全性。
一项针对新诊断为胶质瘤的住院患者的前瞻性研究。
布雷西亚市立医院神经科学与视觉科。
从2006年3月1日至2009年1月1日，176例首次诊断为胶质瘤的连续患者（101例男性和75例女性）纳入本研究。所有诊断为癫痫的患者均接受左乙拉西坦治疗。
分析临床、组织学和磁共振成像结果。
胶质瘤诊断时的年龄为22至79岁（平均[标准差]，57[15]岁；中位数，59岁）。病程为27天至2.5年（平均[标准差]，13.7[7.8]个月；中位数，13个月）。82例患者因诊断为癫痫而接受左乙拉西坦治疗。在最后一次评估（2009年5月1日）时，82例接受左乙拉西坦治疗的患者中有75例（91%）无癫痫发作；其中2例患者因无法耐受的不良反应而停用左乙拉西坦。82例患者中有49例（60%）使用剂量为1500至3000mg/d的左乙拉西坦后癫痫发作得到迅速且持久的控制，9例（11%）接受治疗的患者需要将左乙拉西坦剂量增加至4000mg/d才能无癫痫发作。接受联合化疗的患者未观察到实验室异常。
本研究结果充分证明左乙拉西坦治疗胶质瘤所致癫痫患者有效且安全。
